Objective　To study the characteristics of serious central nervous system(CNS) involvement in childhood systemic lupus erythematosus.Methods　We made a comparison on the level of ANA、dsDNA and positive rate of Sm、C3 between primary and secondary CNS involvement and analysed the clinical manifestations between two groups.Results　The level of ANA、dsDNA and ositive rate of Sm、C3 were not related with SLE encephalopathy;EEG was useful to the diagnosis of SLE.Conclusion　The differiential diagnosis between primary and secondary CNSD in volvement of SLE must be analysed according to clinical manifestations and other laboratory findings.

Objective To evaluate myocardial coronary flow reserve of syndrom X by real-time myocardial contrast echocardiography(MCE). Methods Ten patients with syndrome X and seven normal subjects were involved in the study. Real-time MCE was performed with acoustic contrast SonoVue,and the peak video density (A), and re-turgor velocity of microvessel (β), and the product of A ×β of quiescent condition and after adenosin loading were detected,and also the coronary flow reserve (CFR, the ratio of A xβ circa-adenosin loading). Results There was no significant difference of A between syndrom X and contrast group in quiescent condition, the β and product of A x β of patients with syndrome X were lower than those of contrast group, the CFR of syndrome X was obviously less than that of contrast group.Conclusions Myocardial microvessel function is abnormal in syndrome X, real-time MCE is useful for evaluate myocardial coronary flow reserve.

Multiple myeloma is a more common malignant disease in blood medicine,which is characterized by hyper-proliferation and accumulation of malignant plasma cells in the bone marrow,resulting in a large number of monoclonal immunoglobulins and their fragments,leading to damage to the terminal organs.Of which about 80％ of patients have multiple myeloma bone diseases (MBD),which seriously affected the quality of life and prognosis of patients.We have found that the main cause of MBD are contributed to inhibition of osteoblasts,activation of osteoclast and affecting the occurrence by a variety of cytokines and pathways.This article will review and introduce the occurrence and development of MBD related to the latest factors and treatment.

Objective To explore the reference value of interleukin(IL)-33 and tumor necrosis factor-alpha(TNF)-α in early diagnosis,illness evaluation and prognosis of acute pancreatitis(AP) by dynamically monitoring the serum levels of IL-33 and TNF-α.Methods A total of 86 patients with AP were selected as objectives which were divided into two groups according the severity of illness which include 59 cases of mild AP group(MAP) and 27 cases of severe AP group(SAP),52 cases of systemic inflammatory response syndrome(SIRS) group and 34 cases of non SIRS group distinguished by SIRS,75 cases of survival group and 11 cases of death group identified by prognosis of AP.All of patients were assessed by Bedside Index of Severity in Acute Pancreatitis(BISAP) score within 48 h after admission and detected the serum levels of IL-33 and TNF-α at the first day,third day,seventh day and fourteenth day during hospital.A total of 63 healthy persons were recruited into control group.Results The serum levels of IL-33,TNF-α and BISAP score of SAP group and MAP group were higher than those of the control group in different monitoring time,but the SAP group increased more obviously than MAP group.The serum levels of IL-33 and TNF-α of SAP group were higher than those of MAP group at the first day,third day,seventh day and fourteenth day during hospital,and the differences between them had statistical significance(P<0.05).The serum levels of IL-33 and TNF-α of SAP group increased to peak at the third day and reduced gradually after conventional treatment(the seventh day in the hospital).The serum levels of IL-33 and TNF-α of SIRS group were significant higher than those of non SIRS group(P<0.05).The serum levels of IL-33,TNF-α and BISAP score of death group were significant higher than those of survival group(P<0.05).Spearman correlation analysis suggested that there were positive correlations between BISAP and the serum levels of IL-33 and TNF-α of AP patients.Conclusion There is an important clinical value to the early diagnosis,severity classification,guiding clinical treatment and the assessment of prognosis of AP by dynamically monitoring the serum levels of IL-33 and TNF-αof AP patients.

Echinococcosis is a severe zoonosis parasitic disease and mainly caused by the larvae of Echinococcus granulosus and E. multilocularis. Because of the limitation of operation level,such as recurrence and death,the drug treatment is still the most important method in our country. Meanwhile,the annual number of drug treatments is far greater than surgical treatments. Drugs play a significant role in the preoperative reduction of lesions,reducing pain,extending the life of patients .This article re-views the status of animals treatment and clinical treatment of echinococcosis treated by the benzimidazole drugs and their new formulations,provides the basis for exploring the development direction of anti-echinococcosis drug treatment research.

Objective To explore the application value of tissue dispersion quantitative analysis in rat liver fibrosis stages and provide a reference for clinical non-invasive diagnosis of liver fibrosis.Methods Seventy-two male Wistar rats were randomly divided into experimental group (n =64) and control group (n =8).The experimental groups of rats were gavaged with the volume fraction of 60％ CCl4 olive oil solution to form different stages of liver fibrosis,the control group did wvith normal saline,All the rat underwent tissue dispersion quantitative analysis to obtain 12 elastic parameters,the differences in above parameters were compared among rats with different liver fibrosis stages,then the correlation with pathological stages were analyzed.Results Except for COMP,ASM,CORR,there were significant differences in all parameters among rats of different liver fibrosis (P ＜0.05),which were correlated with pathological stages(P ＜0.05).Among these parameters,％ AREA had the highest correlation coefficient (r =0.891,P =0.001).The ROC curve was made by ％AREA to estimate the fibrosis stage.the area under ROC curve for ％ AREA was 0.914 (≥ the control group + S0),0.963 (≥early liver fibrosis S1 + S2),0.969 (≥middle liver fibrosis S3),0.948 (early cirrhosis S4),respectively.Conclusions The technique of tissue dispersion quantitative analysis has a good evaluation value for liver fibrosis stages,it is able to provide a preliminary reference for clinical non-invasive diagnosis of liver fibrosis.

Objective To compare the effectiveness and safety of glucocorticoid versus intravenous injection of human immunoglobulin (IVIG) in treatment of with acute primary immune thrombocytopenia (ITP) in children. Methods PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database (CBM), Chinese Journal Full Text Database (CNKI) and Wanfang database were searched. The bibliography was screened according to the inclusion and exclusion criteria,and the target literatures were selected. The data were extracted and the quality of included literatures was evaluated. Revman 5 . 3 software was used to make meta-analysis. Results In 1500 papers searched, 8 papers met the inclusion criteria. Meta-analysis showed that there was a statistical signiifcance in platelet count (PLT,>20 × 109/L) after being treated for 48 h between glucocorticoid group and IVIG group (RR=0 . 77 , 95%CI:0 . 67~0 . 89 ). In subgroup analysis, there were statistical signiifcance in methylprednisolone (MP) 30 mg/kg versus IVIG 1 g/(kg·d)× 2 d, and metacortandratin (PDN) 4 mg/kg versus IVIG 1 g/(kg·d)× 2 d (RR=0 . 66 , 95%CI:0 . 47-0 . 91;RR=0 . 79 , 95%CI:0 . 66-0 . 95 ). After treatment for 24 h and 72 h, the platelet count>20 × 109/L were signiifcantly different in glucocorticoid group and in IVIG group (RR=0 . 69 , 95%CI:0 . 53-0 . 91;RR=0 . 82 , 95%CI:0 . 74-0 . 90 ). Moreover, after treatment for 24 h, 48 h and 72 h, the platelet count>50 × 109/L were signiifcantly different between glucocorticoid group and IVIG group (RR=0 . 38 ,95%CI:0 . 21-0 . 69;RR=0 . 53 , 95%CI:0 . 41-0 . 69;RR=0 . 80 , 95%CI:0 . 70-0 . 93 ). There was no difference in the incidence of splenic resection between two groups (RR=5 . 41 , 95%CI:0 . 95-30 . 74 , P=0 . 06 ). Conclusion The probability of platelet count to reach>20 × 109/L in the initial treatment with glucocorticoid of acute ITP patients were 32%lower than that with IVIG. With the initial therapeutic target being platelet count>50 × 109/L in 3 days, the effect of IVIG was better.

BACKGROUND: Is the inhibition of the hematopoietic stem progenitor cell (HSPC) proliferation and differentiation after human cytomegalovirus (HCMV) infection associated with abnormal expression of infected cell proliferated gene?OBJECTIVE: To observe the HOXB6-mRNA expression in the process of proliferation and differentiation of HCMV-infected HSPC into colony-forming unit granulocyte-macrophage (CFU-GM) and colony-forming unit erythroid (CFU-E).DESIGN: A controlled observation.SETTING: Laboratory for Molecular Biology, Affiliated Hospital of Luzhou Medical College, Lanzhou, Gansu Province, China.MATERIALS: All cord blood (CB) specimens were provided by the Obstetrics Department of Affiliated Hospital of Luzhon Medical College. They were collected from the umbilical vein of normal term neonates delivered spontaneously. All neonate mothers were healthy and HBS-Ag-negative. HCMV-IgM antibody revealed by routine ELUSA and HCMV-DNA checked by PCR were undetectable. Written informed consent for the laboratory measurements was obtained from each neonate mother, and the protocol was approved by the hospital's Ethics Committee. HCMV-AD169 strains were obtained from the Institute of Virology, Chinese Academy of Preventive Medicine. All-trans retinoic acid (ATRA, lot No. 20010126) was provided by Chongqing Huapont Pharm. Co., Ltd., China.METHODS: This study was performed at the Laboratory of Molecular Biology (state-level), Affiliated Hospital of Luzhou Medical College of Luzhou Medical College from April 2006 to April 2007. Cord blood mononuclear cells were separated for HSPC culture. According to different interventions, the study consisted of 4 groups. Control group: no HCMV virus solution was added and equal volume of culture medium was added instead. HCMV group: 105 PFU/mL HCMV-AD169 virus solution was added to the culture system. ATRA group: ATRA was added into the cultivation system at the final concentration of 60 μ mol/L. HCMV+ATRA group: ATRA was added into the HCMV group, and its final concentration was also 60 μ mol/L.MAIN OUTCOME MEASURES: In each group, cells were harvested on days 3,7 and 12. HOXB6 mRNA expression levels in CFU-GM and CFU-E were detected by real-time fluorescent-based quantification PCR.RESULTS: In the control group, both CFU-E and CFU-GM expressed HOXB6-mRNA. The HOXB6 mRNA expression was increased as a function of time. The HOXB6-mRNA expressed by CFU-E reached its peak level on day 12, while that expressed by CFU-GM reached its peak level on day 7. Compared to control group, the expression levels of CFU-E and CFU-GM HOXB6-mRNA genes in normal cord blood were significantly lower in the HCMV group (P＜0.05)and significantly higher in the ATRA group (P＜0.05) at each time point after HCMV infection. Furthermore, the expression levels were significantly higher in the ATRA+HCMV group than in the HCMV group at each time point(P＜0.05-0.01).CONCLUSION: HOXB6-mRNA expression is stable and lasting in the proliferation and differentiation of HSPC into CFU-GM and CFU-E. HCMV could down regulate HOXB6 gene expression, and ATRA could up regulate HOXB6 gene expression.

BACKGROUND: Clinically, in patients undergoing hematopoietic stem cell transplantation (HSCT), human cytomegalovirus (HCMV) can be associated with delayed platelet engraftment, phenotypically abnormal peripheral blood leukocytes, and graft rejection, possibly through a direct viral effect on hematopoietic progenitor cells after HCMV infection. OBJECTIVE: To investigate the inhibitory effect of ganciclovir (GCV) on proliferation of colony forming unit (CFU) granulocyte-macrophage (CFU-GM), CFU-erythroid (CFU-E), CFU T-lymphocyte (CFU-TL), CFU-multipotential (CFU-Mix) and CFU-megakaryocyte (CFU-Mk) progenitor cells of cord blood (CB) and the protective effects on them. DESIGN: Contrast observational study.SETTING: Department of Molecular Biology, Affiliated Hospital of Luzhou Medical College.PARTICIPANTS: A total of 20 cord blood (CB) samples (with 10 mL for each sample) from fetal umbilical vein of normal term spontaneous delivery neonates were provided by the Department of Gynaecology and Obstetrics, Affiliated Hospital of Luzhou Medical College. All the patients were informed and agreed with the experiment.METHODS: The experiment was carried out in the Department of Molecular Biology, Affiliated Hospital of Luzhou Medical College from June 2004 to December 2006. Colony forming unit-assay was applied to observe the suppression effect of HCMV-AD169 strain on CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk of CB with the presence of GCV. The techniques of polymerase chain reaction (PCR) and fluorescence quantification PCR were used to demonstrate the existence of HCMV-AD169 DNA in the colony cells of cultured CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk. Normal progenitor cells culture system was regarded as blank control group; normal progenitor cells culture system with inactivated HCMV fluid as inactivated (IV) control group.MAIN OUTCOME MEASURES: ① The number and maintaining duration of colonies of cultured progenitor cells were counted by using a light inverted phase contrast microscope. ② The techniques of PCR and fluorescence quantification PCR were used to demonstrate the existence of HCMV-AD169 DNA in the colony cells of cultured progenitor cells.RESULTS: ① Number and lasting time of colonies: The numbers of CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk colonies in the HCMV infection group were significantly less than those in the blank control group (P < 0.01). The maintaining duration of colonies in the HCMV infection group was significantly shorter than that in the blank control group (P < 0.01). HCMV-DNA copies of colony cells of GCV group decreased significantly by using fluorescence quantification PCR compared with HCMV group (P < 0.01), while negative in blank control and inactivated control in CFU-MK and CFU-Mix. ② CFU Growth rate: The Growth rate of colonies was 37.4%, 74.2%, 40.1%, 67.4% and 38.9% of CFU-GM, CFU-E, CFU-TL, CFU-Mix and FU-MK, respectively. ③ CFU-HCMV-AD169 DNA: Fluorescence quantification PCR showed that nucleonic acid content of progenitor cells after GCV-affected HCMV infection was decreased as compared with that after HCMV infection (P < 0.01).CONCLUSION: The differentiation and proliferation of CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk are significantly inhibited after infected with CMV-AD169 strain. The growth of hematopoietic progenitor cell after HCMV-AD169 infection is promoted by GCV, which suggests that GCV has an effect of anti-HCMV in vitro.

OBJECTIVE: To provide reference for establishing and improving clinical pharmacists' working mode in women-children special hospital.METHODS: The work carried out by clinical-medical-nursing team and the situation of clinical pharmacists' involvement in clinical treatment were summarized retrospectively.RESULTS & CONCLUSIONS: The medication safety in women-children special hospital has specificity and urgency,and the establishment of clinical-medical-nursing team is an important approach to realize clinical safe and rational drug use.A platform for clinical pharmacists under unified management of organization and system requirement should be set up in hospital to explore a clinical pharmacy working mode with the characteristics of special hospital,carry out clinical pharmacy research and search for quality management and performance management method for clinical pharmacists.