Adult ; Chromosome Aberrations ; drug effects ; Ethylene Oxide ; poisoning ; Humans ; Lymphocytes ; drug effects ; pathology ; Male ; Micronuclei, Chromosome-Defective ; drug effects

The clinical efficacy and safety of auricular acupuncture (AA) for treatment of primary insomnia was evaluated. After a comprehensive retrieval in domestic and foreign databases, literatures were strictly screened and Revman 5.2 software was applied to perform a Meta-analysis on eligible randomized controlled trials (RCTs). The evidence quality was assessed with GRADE profiler 3.6 software. As a result, 8 articles were included involving 894 patients. Compared among AA and sham AA, placebo AA, blank control, there was significant difference in Pittsburgh sleep quality index (PSQI) [WMD = -3.48, 95% CI (-3.96, -3.00)], sleep latency LWMD = -10.14, 95% CI (-17.16, -3.12)] and sleep awakening times [WMD = -9.98, 95% CI (-1.10,-0.48)]. Compared between AA and western medication, there was significant difference in PSQI [WMD = -3.62, 95% CI (-4.59, -2.65)]. The evidence quality was moderate in AA vs. sham AA, placebo AA or blank control, while that of the rest was extremely low. No reports of adverse events were described in all studies. In conclusion, for the treatment of primary insomnia, AA could effectively improve sleep quality, but due to the low evidence quality, cautious attitude should be taken on this conclusion, and clinical trials with large sample and high quality were needed in the further.
Acupuncture, Ear ; Humans ; Randomized Controlled Trials as Topic ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy

Objective To discuss the clinical features and treatment of isovaleric academia (IVA) patients,and to gain more comprehensive understanding of isovaleryl-CoA dehydrogenase(IVD) mutation in 2 siblings in order to raise awareness to prevent the occurrence of IVA.Methods The clinical history and laboratory test of 2 cases of children with IVA were carried out.The exons and neighboring introns of IVD gene of the whole family were PCR-amplified for DNA sequencing.The literature review of IVA in China was also conducted.Results Organic acid analysis of urine by GC/MS for both siblings showed extremely elevated concentrations of isovaleric glycine.For the older sibling,an acute episode of IVA caused severe metabolic stress and eventually death in the neonatal period.However,the disease was well-controlled for the younger sibling due to timely treatment and follow-up care for 2 years.The DNA sequencing of the IVD gene in the family revealed a novel c.1016G ＞ A(C339Y) heterozygous mutation in mother and both of the siblings.No IVD mutation was detected in father or in any of the 50 cases of healthy controls.According to literature review,15 cases of IVA were reported in recent 15 years in China,including neonatal onset (11 cases),acute episode (12 cases),odor of sweaty feet (12 cases),pancytopenia (9 cases),hyperammonemia (5 cases),hypocalcemia (6 cases),and 6 cases of death were reported.Additionally,5 cases that received treatment of BCAA-free formula milk showed positive outcome.However,only 2 cases were followed up for more than 2 years.Conclusions Two new IVA patients carrying c.1016G ＞ A(C339Y) mutation were reported in China.The mutation may lead to conformational change and functional deficient of the IVD protein.It is also necessary to point out that using direct DNA sequencing can not identify all patients with IVA due to limitations of this technology,and thus clinicians should be aware of the possibility of genetic misdiagnosis.Moreover,there is a trend of increasing IVA in China in recent years.

BACKGROUND: Although we have gained much information about leadinduced organ damage, the effect of blood lead level on T cell subgroup is yet to be determined.OBJECTIVE: To assess the effect of blood lead level on T cell subgroup of children, and the association of T cell subgroup with threshold limit value of blood lead level.DESIGN: Comparative observation.SETTING: The Institute of Molecular Microorganism, Maternity and Child Care Hospital, Shanxi Provincial Children Hospital.PARTICIPANTS: Sixty children, (32 boys and 28 girls), aged 3-6 years with a mean of (4.5±1.5) years old, were selected from the suburbs of Taiyuan city between May 2003 and October 2003. Informed consents were obtained from all their guardians. The enrolled children according to their blood lead levels were assigned into three groups, 13 in Group Ⅰ with blood lead level ≥ 0.48 μmol/L, 20 in Group 2 with lead level ≥ 0.24 μmol/L but ＜ 0.48 μmoL/L and 27 in Group 3 with lead level ＜ 0.24 μmol/L.METHODS: Blood lead level and expression of T cell subgroup were measured with graphite furnace atomic absorption spectroscopy and immunofluorescence methods respectively. Student t test was used in data analysis, and linear correlation analysis was used to assess the correlation between blood lead level and expression of T cell subgroup.level and expression of T cell subgroup.pression of CD3 and ratio of CD4 to CD8 were lower in Group 1 (lead level ≥0.48 μmol/L) than Group 3 (lead level ＜ 0.24 μmol/L) (t=3.27,blood lead level showed had significant inverse correlation with CD3 expression and the ratio of CD4 to CD8(r=-0.689,-0.674,P ＜ 0.01).CONCLUSION: A blood lead level ≥ 0.48 μmol/L, is shown to significantly decrease the expression of CD3 and ratio of CD4 to CD8 in peripheral blood, which may impair the children's immunological function.

BACKGROUND: Although we have gained much information about leadinduced organ damage, the effect of blood lead level on T cell subgroup is yet to be determined.OBJECTIVE: To assess the effect of blood lead level on T cell subgroup of children, and the association of T cell subgroup with threshold limit value of blood lead level.DESIGN: Comparative observation.SETTING: The Institute of Molecular Microorganism, Maternity and Child Care Hospital, Shanxi Provincial Children Hospital.PARTICIPANTS: Sixty children, (32 boys and 28 girls), aged 3-6 years with a mean of (4.5±1.5) years old, were selected from the suburbs of Taiyuan city between May 2003 and October 2003. Informed consents were obtained from all their guardians. The enrolled children according to their blood lead levels were assigned into three groups, 13 in Group Ⅰ with blood lead level ≥ 0.48 μmol/L, 20 in Group 2 with lead level ≥ 0.24 μmol/L but ＜ 0.48 μmoL/L and 27 in Group 3 with lead level ＜ 0.24 μmol/L.METHODS: Blood lead level and expression of T cell subgroup were measured with graphite furnace atomic absorption spectroscopy and immunofluorescence methods respectively. Student t test was used in data analysis, and linear correlation analysis was used to assess the correlation between blood lead level and expression of T cell subgroup.level and expression of T cell subgroup.pression of CD3 and ratio of CD4 to CD8 were lower in Group 1 (lead level ≥0.48 μmol/L) than Group 3 (lead level ＜ 0.24 μmol/L) (t=3.27,blood lead level showed had significant inverse correlation with CD3 expression and the ratio of CD4 to CD8(r=-0.689,-0.674,P ＜ 0.01).CONCLUSION: A blood lead level ≥ 0.48 μmol/L, is shown to significantly decrease the expression of CD3 and ratio of CD4 to CD8 in peripheral blood, which may impair the children's immunological function.

Objective To investigate the relationship between apoptosis of bone marrow cells and tumor necrosis factor-?(TNF-?),Fas/FasL expression in children with aplastic anemia.Methods The concentration of TNF-? in supernatant of cultured bone marrow mononuclear cell(BMMC) was measured by enzyme linked immunosorbent assay.The expression of Fas/FasL,apoptosis ratio of bone marrow CD34+ cell were evaluated by flow cytometry.Results The concentration of TNF-? in supernatant of cultured BMMC in AA group[SAA (27.9?8.20) ng/L;CAA (23.6?6.78) ng/L] increased significantly compared with control group(t=3.432 P0.05).Apoptosis ratio of CD34+ cell in SAA group[(24.6?9.56)%] and CAA group[(20.9?7.32)%] significantly increased compared with control group(t=3.492,3.458 Pa0.05).The concentration of TNF-? was positively correlated with the expression of CD34+ Fas+ in all types AA children(r=0.542 P0.05).Conclusions TNF-? and Fas/FasL system can be involved in inducing CD34+ cell apoptosis.This may contribute to understanding the decreased number of stem cells and bone marrow failure.

Objective To investigate the feasibility of semiconductor gene sequencing technology for thalassemia clinical screening and evaluate its application as compared with the results of PCR technology.Methods 197 visiting patients were randomly selected as prospective samples and200 patients ever diagnosed with thalassemia as previous samples.All the samples were detected by semiconductor technology gene sequencing and PCR technology at the same time and then evaluation of the advantage of semiconductor gene sequencing technology.Results 22 cases of 197 prospective samples were detected as thalassemia mutations by PCR technology,including 18 cases of α-thalassemia,3 cases of β-thalassemia,1 case of oα merge β thalassemia mutations.Semiconductor technology gene sequencing detected another 6 cases of rare type of thalassemia.By semiconductor gene sequencing technology on previous samples,118 cases of α-thalassemia,65 cases of β-thalassemia,17 case of α merge β thalassemia mutations,1 case of thalassemia mutations (HBA 1:c.223G ＞ C) were detected.By statistical analysis,the total coincidence rate of PCR technology and semiconductor gene sequencing was 98.5％,withthe Kappa =0.97(≥ 0.8).Conclusion Semiconductor gene sequencing technology for thalassemia clinical screening is feasible,for it can detect both thalassemia gene type,and new mutation.The results of semiconductor gene sequencing technology are accurate and the technology could be popularized in clinical application.

Objective    To analyze the effect of different drainage modes on the postoperative thoracic drainage after video-assisted thoracoscopic surgery for radical resection of lower lung carcinoma. Methods    A total of 183 patients with non-small cell lung cancer who received biportal thoracoscopic anatomical lower lobectomy combined with mediastinal lymph node dissection in the First Affiliated Hospital of Xi'an Jiaotong University from August 2017 to August 2019 were enrolled, including 113 males and 70 females, aged 31-77 (56.5±6.4) years. The patients were randomly divided into three groups, including an anterior axillary line group, a mid-axillary line group and a modified anterior axillary line group. Clinical efficacy of the three groups was compared. Results    No significant difference among these three groups in terms of gender, age, surgical site, pathological type, pathological staging, postoperative chest wall subcutaneous emphysema, postoperative pain score, and postoperative hospital stay was found (P>0.05). There were significant differences among the patients in terms of postoperative pleural effusion, re-insertion of chest tube or aspiration, total liquid quantity of thoracic drainage, drainage time and chest wall incision stitches time (P<0.05). The anterior axillary line group had higher risk of postoperative pleural effusion than the other groups (P<0.05). The occurrence of postoperative pleural effusion and rate of reposition of chest tube or aspiration were significantly reduced in the modified anterior axillary line group (P<0.05). Conclusion    Chest drainage tube with large diameter (24F) in the 5th intercostal space of the anterior axillary line combined with another micro-tube (8.5F) in the 7th or 8th intercostal space of the inferior scapular angle line can shorten drainage time to reduce postoperative pain, reduce the occurrence of postoperative pleural effusion, and shorten the time of surgical incision stitches.

OBJECTIVERett syndrome (RTT) is a neurodevelopmental disorder which causes severe mental retardation. This study aimed at elucidating clinical features of 66 Chinese RTT cases diagnosed by The Department of Pediatric Neurology, Peking University First Hospital since 1987, and at analysis of the MeCP2 genotype / phenotype correlation.

METHODSSixty-six RTT cases were followed up every one to two years to get the information of their clinical manifestations and the response to the L-carnitine treatment which was administered to the patients at a dose of 80-100 mg/(kg d). MeCP2 mutation analysis by PCR and sequencing were performed on 39 cases.

RESULTSIn this cohort of cases, the onset of the disease occurred between 3 and 38 months of age, 89% of the cases lost their purposeful hand use at 7 months to six years of age, all the cases had stereotype hand movement which presented at 1 to 5 years of age, 85% of the cases lost language ability at 11 months to eight years of age, 21% of the cases lost the ability of walking at ages of 2 years and 9 months to 15 years. The symptoms/signs such as small head circumference, seizures, breathing irregularities, teeth grinding, scoliosis/ kyphosis were presented in many of the cases. The clinical manifestations were improved in 6 cases after L-carnitine treatment. MeCP2 gene mutation was found in 64% of the cases. Two cases with non-sense mutation C502t (amino acid change R168X) died, two cases with missense mutation C397T (amino acid change R133C) and one case with missense mutation A398T (amino acid change R133H) preserved several words.

CONCLUSIONDeceleration of the head growth, loss of acquired purposeful hand use, stereotype hand movement and language deterioration were the main characteristics of RTT. L-carnitine could improve the clinical manifestation of some cases. There are some correlations between MeCP2 genotype and phenotype.

Adolescent ; Carnitine ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Chromosomal Proteins, Non-Histone ; genetics ; DNA Mutational Analysis ; DNA-Binding Proteins ; genetics ; Female ; Follow-Up Studies ; Genotype ; Hospitals, University ; Humans ; Infant ; Male ; Methyl-CpG-Binding Protein 2 ; Mutation ; Phenotype ; Repressor Proteins ; genetics ; Rett Syndrome ; drug therapy ; genetics ; pathology ; Treatment Outcome

Objective To investigate the effects of Lp(a)on proliferation GMCs of rat model induced by lipopolysaccharide and explore the possible mechanism of Lp(a)in the proliferation of rat GMCs.Methods To observe the effects of Lp(a)on proliferation of GMCs,different dosage of Lp(a)were used,The research were divided into three groups:Control group,LPS group,Lp(a)group.After culture(at the end of 12h,24h,48h,60h and 72h),the cultured GMCs and suspension were collected to observe the rate of GMCs proliferation by MTT,the positive rate of proliferation cell nuclear antigen(PCNA)by immunohistochemisty,and the level of intercellular adhesion molecule-1(ICAM-1)by ELISA respectively.Results Compared with control and LPS group,MTT,positive rate of PCNA and ICAM-1 of GMCs were increased more significantly in Lp(a)group.MTT ,the positive rate of PCNA and ICAM-1 of GMCs were increased as Lp(a)dosage increased,a maximal effect was seen when Lp(a)was 2.5 μg/L or 5.0μg/L.When the dosage continue increased,MTT,the positive rate of PCNA and ICAM-1 activity of GMCs began to decrease in Lp(a)group.ICAM-1 showed positive correlation with MTT and the positive rate of PCNA.Conclusion Lp(a)can significantly affect the rate of GMCs proliferation,and this affection is in a dosage-and timedependent manner.Low dosage stimulates GMCs proliferation, and high dosage inhibits GMCs proliferation.ICAM-1 shows positive correlation with MTT and the positive rate of PCNA.The effect of Lp(a)on GMCs may be through ICAM-1.