Objective To explore the risk factors for intracranial hemorrhage caused by late vitamin K deficiency bleeding(VKDB),in order to prevent and reduce the incidence of intracranial hemorrhage caused by late VKDB.Methods A retrospective analysis of the risk factors of late VKDB and intracranial hemorrhage was applied to 2 groups of patients in PICU and department of neurology of Beijing children's Hospital from Jan.2002 to Dec.2007.In group Ⅰ,there were 90 patients suffering from intracranial hemorrhage caused by late VKDB;while in group Ⅱ,there were 23 patients of late VKDB without intracranial hemorrhage.Within 12 hours of hospitalization,the following 9 items were checked:the cranial CT,blood calcium concentration,liver function,serum sodium,blood glucose,prothrombin time,partial thromboplastin time,fibrinogen concentration,and platelet.Ten possible relevant risk factors of gender,age,birth situation,feeding patterns,recent diarrhea,cytomegalovirus(CMV)infection,hypocalcemia,dysglycemia,hyponatremia,and abnormal liver function were analyzed by the method of non-conditional Logistic regression analysis.Results Statistically significant difference had been found in the 3 factors of hypocalcaemia,recent diarrhea,abnormal liver function(Pa

The interaction between warfarin and bovine serum albumin (BSA) under pseudophysiological conditions was investigated by UV-Vis absorption spectrometry and spectrofluorimetry. The quenching mechanism of BSA by warfarin was discussed. It showed that the quenching process was a dynamic quenching, and the quenching constants were 6.05 x 10(4) L x mol(-1) at 16 degrees C and 6. 14 x 10(4) L x mol(-1) at 37 degrees C, separately. Based on the Förster theory of non-radiative energy transfer, the energy transfer efficiency and the distance of BSA to warfarin were calculated, which was 0.37 and 3.15 nm, respectively.
Energy Transfer ; Protein Binding ; Serum Albumin, Bovine ; chemistry ; Spectrometry, Fluorescence ; methods ; Spectrophotometry, Ultraviolet ; methods ; Thermodynamics ; Warfarin ; chemistry

Professor Shao Jing-ming had practiced Chinese medicine for more than 80 years with rich clinical experience and exquisite acupuncture techniques. From his clinical experience, Professor Shao's clinical features can be summarized as the followings: attaching importance to the theory of meridians and collaterals, combining pattern identification and disease identification, using fewer acupoints for treatment, and using Ashi point and Hegu (LI 4) to treat goiter. He emphasized the priority and sequence in acupoint-selection and manipulation. In treatment of epilepsy, he proposed to treat it according to the situation and paid great attention to the special function of the extraordinary acupoints. During the onset, it should be managed by calming the mind and controlling the symptoms; during the remission period, acupuncture and drugs should be applied simultaneously to regulate qi-blood and yin-yang, so as to reduce the frequency of attacks. He believed that acupuncture manipulation be one of the key factors in achieving the efficacy. In treatment of the motive diseases, such as convulsions and cramps, acupuncture with static and longer needle-retaining time should be adopted to control the limb movement, to strengthen the stimulation and to obtain a long-term efficacy. Professor Shao Jing-ming's medical records range from internal medicine, external medicine, gynecology and pediatrics, listing various refractory diseases effectively treated by him. Professor Shao was a moral and erudite Chinese medicine master, and his clinical experience is worthy of inheritance and development.

Objective To investigate the effects of rigid gas permeable contact lens (RGPCL) wearing 3 years on ocular surface in keratoconus.Design Retrospective case series.Participants 73 patients with keratoconus.Methods From July 2001 to July 2004,73 patients (142 eyes) wearing RGPCL for more than 3 years were collected in Peking University Optometry & Ophthalmology Center.Be- fore and at 1 year,2 years and 3 years of RGPCL wearing,density and morphologic changes of corneal endothelium were examined with non-contact specular microscope.Eye axial length,central and peripheral thickness of cornea were measured with A-scan pachymeter. All eyes were examined with slit-lamp microscope periodically.Main Outcome Measures Corneal endothelial density and morphology, corneal thickness,eye axial length,ocular surface changes.Results Before and at 1 year,2 years and 3 years of RGPCL wearing,aver- age corneal endothelial density was 2901.92?445.20,2862.78?497.13,2854.71?526.80,3015.61?421.22 (cells/mm~2)without significant difference statistically (F=1.571,P=0.20).Morphologic changes were not significant during 3 years.Eye axial length was 25.15?1.50, 24.93?1.36,24.78?1.25,25.39?1.31 (mm) without significant difference statistically (F=2.218,P=0.10).Corneal central thickness was 489.09?59.64,484.02?60.80,496.61?59.74,487.44?54.25(?m)without significant difference statistically (F=0.991,P=0.40).Peripheral thickness changes were also not significant statistically during 3 years.69 eyes with mild conjunctival congestion,12 eyes with corneal fluorescence stain and 6 eyes with corneal epithelial rough were found with slit-lamp microscope during follow-up.Conclusions For the patients with keratoconus,long term of RGPCL wear will not lead to significant ocular changes or severe ocular complications.

OBJECTIVETo investigate the incidence of posttraumatic stress disorder (PTSD) and its influencing factors for three years following the "5.12" Wenchuan Earthquake.

METHODSA systematic sampling of 870 subjects who came from Beichuan (605 persons) and Jiangyou (265 persons) areas were investigated by adopting subscale of PTSD Checklist-Civilian Version (PCL-C) and Social Demographic Questionnaire.

RESULTSThe incidence rate of PTSD was 8.5% (74/870), the incidence rates of PTSD for the area of Beichuan and Jiangyou were 11.2% (68/605) and 2.3% (6/265) respectively. Subjects from Beichuan had higher PTSD incidence rate compared to Jiangyou (P < 0.05). The prevalence of PTSD for female and male were 11.8% (55/465) and 4.7% (19/405) respectively, female had higher prevalence of PTSD compared to male (P < 0.05). The incidence rates of PTSD for victims who suffered from major property lost and those who lost less were 13.3% (62/466) and 3.0% (12/404) respectively, victims suffered major property lost had higher incidence rate of PTSD(P < 0.05). The incidence rates of PTSD for victims who lost family members and those did not were 13.4% (45/336) and 5.4% (29/534) respectively, victims who lost family members had higher incidence rates of PTSD (P < 0.05). The posttraumatic symptoms for survivors who suffered from PTSD mainly focused on the symptoms of reexpericement and over vigilance, the prevalence rate was 100% (74/74). Exaggerated startle response, intense psychological distress and physiological reactivity were higher than others in total 17 symptoms, accounting for 96% (71/74), 94% (70/74) and 90% (67/74). The logistic regression showed that being female, victims who suffered from major property lost, lost family member in this earthquake were the risk factors of PTSD, and the values of OR (95%CI) were 2.746 (1.580 - 4.772), 3.616 (1.871 - 6.988) and 1.805(1.057 - 3.084), respectively.

CONCLUSIONPosttraumatic symptoms were still common among survivors three years after "5.12" Wenchuan Earthquake. Survivors in Beichuan (heavy hit area), female victims, victims who suffered from major property lost, victims who lost family member need more social and economic support.

Adolescent ; Adult ; China ; epidemiology ; Disasters ; Earthquakes ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Risk Factors ; Stress Disorders, Post-Traumatic ; epidemiology ; Stress, Psychological ; Surveys and Questionnaires ; Survivors ; psychology ; Young Adult

Background Corneal epithelial abrasion results in corneal ulcer and stroma cloudy evenb irreversible visual impairment.Previous drugs for corneal epithelial injury can only alleviate the inflammatory irritation.So it is very important to seek a drug which regulate the growth of corneal epithelium.Objective This study was to investigate the effects of recombinant human BIGH3 protein eye drops on corneal epithelial abrasion.Methods Fifty right eyes of 50 clean adult New Zealand white rabbits were collected.Two rabbits were sacrificed right away following establishment of corneal epithelial abrasion models (0 hour group).The other 48 rabbits were randomly divided into recombinant human epidermal growth factor (EGF) derivative group (positive control group),normal saline solution group (negative control group),0.25％ or 0.5％ recombinant human BIGH3 protein eye drops group.Corneal abrasion models were created with alcohol corrosion method with a defect area of 7 mm2.The corresponding eye drops were used separately in 4 groups for four times per day after operation.Experimental eyes were examined by the slit lamp microscope,and fluorescein vital staining were performed 12,24,36,48,72 hours after operation.Planimetry was performed and the corneal photographs were analyzed with computer software.The rabbits were sacrificed 12,24,36,48 and 72 hours after operation,respectively,and the histopathological examination of corneal tissue was carried out.Results No obvious irritation response was seen after administered of eye drops in the recombinant human EGF derivative group,normal saline solution group,0.25％ and 0.5％ recombinant human BIGH3 protein eye drops groups.Histopathological examination revealed a full-thickness defect of corneal epithelium after modeling.The defect area was gradually smaller with time lapse,and corneal epithelium migrated from periphery toward the center zone.Corneal epithelial cells increased with time lapse.Compared with normal saline solution group,the defect area of corneal epithelium lessened 12,24,36,48 hours after operation in the 0.25％,0.5％ recombinant human BIGH3 protein eye drops groups and recombinant human EGF derivative group (all at P =0.000),but at 12and 24,36 hours after operation,no significant differences were found between the recombinant human EGF derivative group and normal saline solution group (P =0.321,0.057,0.126).The defect area was smaller in the 0.5％recombinant human BIGH3 protein eye drops group than that of the recombinant human EGF derivative group at various time points (P=0.042,0.039,0.025,0.008).However,significant smaller defect area was exhibited only at 12 hours and 24 hours after operation in the 0.25％ recombinant human BIGH3 protein eye drops group (P=0.047,0.042).No significant differences were seen in corneal defect area at various time points between 0.25％ and 0.5％recombinant human BIGH3 protein eye drops groups (P =0.358,0.259,0.108,0.062).In addition,the corneal defect area was (0.51 ±0.42)mm2 72 hours after operation in the normal saline group;while that in the recombinant human EGF derivative group and recombinant human BIGH3 protein eye drops groups was disappeared.The repairing curves in the recombinant human BIGH3 protein eye drops groups were superior to those of the recombinant human EGF derivative group and normal saline solution group.Conclusions 0.25％ and 0.5％ recombinant human BIGH3 protein eye drops have facilitation effect on the growth of corneal epithelial cells and the healing of corneal injury.

Objective To determine the relationship between chronic diseases and cognitive function in elderly patients, for the purpose of preventing and alleviating cognitive malfunction. Methods A total of 100 retired high intellectuals with age older than 65 years were enrolled.They were hospitalized in Zhongshan Hospital and were requested to complete a conventional questionnaire.Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) Scale.Their chronic diseases including hypertension, coronary artery disease, diabetes mellitus were recorded and compared among subjects with different cognitive function levels. Results Based on MoCA Scale, 34 cases were sorted as having normal cognitive function, 50 cases as mild cognitive impairment, and 16 cases as moderate cognitive impairment.Patients with moderate cognitive impairment showed a significantly higher percentage of hypertension (93.8%), coronary artery disease (75.0%), stroke (56.3%), diabetes mellitus (56.3%) while the patients with normal cognitive function exhibited relatively lower percentage of the above-mentioned diseases (61.8%, 41.2%, 17.6%, 20.6%, respectively, P < 0.05).However such difference was not observed for respiratory disease and neoplastic disease among patients with different cognitive conditions (P>0.05).In addition, cardiovascular and metabolic diseases were found to be important risk factors of mild-to-moderate cognitive impairment (P=0.002). Conclusion Prevention and treatment of cardiovascular and metabolic diseases could be imperative to alleviate the process of cognitive impairment.

BACKGROUNDPreS/S gene was derived from hepatitis B virus (HBV) integration fragment of human hepatocellular carcinoma genome, containing the promoter of preS/S and the C terminal truncated preS/S open reading frame. PreS/S protein may have important roles in processing hepatoma in some HBV-infected patients. The aim of the study was to study the activity of HBV preS/S protein on proliferating cell nuclear antigen (PCNA) promoter and to localize compartment of the preS/S protein in the liver cell line L02.

METHODSThe authors studied the effect of the 3 -truncated preS/S on human PCNA promoter by co-transfecting the expression plasmids of luciferase reporter gene, used the immunohistochemical method to localize the preS/S protein.

RESULTSThe expression product of the plasmid, pKSH7C-HpaI which contained the 3 -truncated preS/S and the flanking cellular sequences, stimulated the expression of PCNA promoter dose dependently,and its effect was 0.5 folds higher than control. Immunohistochemistry showed that the preS/S protein located in the cytosolic region of the liver cell line L02.

CONCLUSIONSThe HBV preS/S protein could stimulate the PCNA promoter of the liver cell, its effect was not direct, which suggests that the effect of preS/S protein on PCNA promoter was probably through the cell signal transduction pathway.

Carcinoma, Hepatocellular ; genetics ; virology ; Hepatitis B Surface Antigens ; genetics ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; genetics ; virology ; Proliferating Cell Nuclear Antigen ; genetics ; Promoter Regions, Genetic ; Protein Precursors ; genetics ; Tumor Cells, Cultured ; Virus Integration

BACKGROUNDNon-invasive nasopharyngeal carcinoma (NPC) screening usually involves serological testing for the presence of IgA antibodies to Epstein-Barr virus (EBV) capsid antigen (VCA). The present meta-analysis determined the accuracy of VCA-IgA in the diagnosis of NPC.

METHODSA systematic review of studies was conducted and data on the accuracy of VCA-IgA concentrations in the diagnosis of NPC were pooled using random effects models. Receiver operating characteristic curves were used to summarize the overall test performance.

RESULTSTwenty studies met the inclusion criteria for the meta-analysis. The summary estimates for VCA-IgA in the diagnosis of NPC were: sensitivity 0.91 (95% confidence interval (CI): 0.90 - 0.92), specificity 0.92 (95%CI: 0.92 - 0.93), positive likelihood ratio 31.65 (95%CI: 10.99 - 91.15), negative likelihood ratio 0.10 (95%CI: 0.07 - 0.13) and diagnostic odds ratio 414.59 (95%CI: 174.96 - 982.42). The area under the summary receiver operating characteristic curves was 0.98.

CONCLUSIONThe sensitivity and the specificity of serum VCA-IgA are very high, suggesting that the presence of VCA-IgA in peripheral blood is a valuable predictor for NPC.

Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Carcinoma ; diagnosis ; immunology ; Humans ; Immunoglobulin A ; immunology ; Nasopharyngeal Neoplasms ; diagnosis ; immunology

OBJECTIVETo evaluate the effect of tetra-arsenic tetra-sulfide (As4S4) therapy on the corrected QT interval (QTc) in the acute promyelocytic leukemia (APL) patients.

METHODSNinety cases of APL treated with As4S4 were divided into two groups--the remission induction group and maintenance therapy group. Blood arsenic concentration was measured and a 12-lead electrocardiogram (ECG) was simultaneously performed before treatment and after remission in the induction group, and before and 2, 4, 6, 8, 10 courses after the treatment in the maintenance therapy group. QT interval on each ECG was measured and corrected by the Bazett formula.

RESULTSOral administration of As4S4 could lead to the prolongation of QTc both in remission induction and maintenance therapy groups. QTc prolongation was related to the doses of As4S4 and blood arsenic levels. QTc prolongation and its variation range were increased with accumulative doses of As4S4 and the blood arsenic levels. In ten courses maintenance therapy patients, the average abnormal rate of QTc was 37.7%. Blood arsenic concentration was increased slowly with courses, but the variation had no statistical difference (P > 0.05). All the patients whose QTc was abnormal (> or = 440 ms) had neither symptoms nor serious cardiac events, such as ventricular tachycardia and Torsade de pointes and could complete the As4S4 therapy.

CONCLUSIONAlthough As4S4 therapy can lead to QTc prolongation in the treatment of APL patients, it does not preclude the completion of the therapy.

Adolescent ; Adult ; Antineoplastic Agents ; pharmacology ; Arsenicals ; pharmacology ; Electrocardiography ; drug effects ; Female ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; physiopathology ; Male ; Middle Aged ; Sulfides ; pharmacology