Autoimmune Lymphoproliferative Syndrome ; classification ; diagnosis ; immunology ; physiopathology ; therapy ; Child, Preschool ; Diagnosis, Differential ; Disease Progression ; Humans ; Infant ; Treatment Outcome

Objective To study the causes of early death of patients with acute severe cervical spinal cord injury.Methods A retrospective analysis was done on 78 cases of acute severe cervical spinal cord injury,who were treated in our hospital between January 2003 and December 2007.The patients were divided into death group and survival group(survived more than 30 days after the injury).The clinical data including age,level of spinal cord injury,time of injury and admission,surgical treatment,duration between injury and surgery,neurogenic shock,central hyperthermia,hyponatremia,serum level of albumin,percentage of lymphocytes in serum,tracheotomy,and pulmonary infection,were recorded and analyzed. Results The proportion of high-level spinal cord injures(C1-C4) in death group(8/9) was significantly higher than that in the survival group(49/69,?2=18.086,P=0.000).Whereas the duration between injury and surgery in the death group was significantly shorter than that in the survival group(1-12 d,median 2 d vs 1-39 d,median 3 d;Z=-2.664,P=0.008).In the death group,4 of the 9 patients had neurogenic shock,and 4 developed hyponatremia,which were significantly more than those in the survival group(6/69,?2=12.392,P=0.000;19/69,?2=4.526,P=0.033).The percentage of peripheral lymphocyte on admission was(11.84?5.80)% in the death group,which was significantly lower than that of the survival group(19.17?16.64)%(t=-4.006,P=0.000).In the death group,7 patients received tracheotomy,and 8 patients showed pulmonary infection,the proportions were significantly higher than those in the survival group(10/69,?2=29.749,P=0.000;and 15/69,?2=17.266,P=0.000).Conclusions Several factors,including high-level injury(C1-C4),neurogenic shock,pulmonary shock,and tracheotomy,may cause the death of patients with acute severe cervical spinal cord injury in an early stage.

Objective To investigate the relevant factors of early stage hyponatremia in patients with complete cervical spinal cord injury (CSCI). Methods A retrospective study was conducted in consecutive 49 individuals with complete CSCI from January 2010 to December 2015.The diagnostic criteria for hyponatremia was two consecutive tests (interval <24 h) of serum sodium <135 mmol/L.Twenty-six patients with hyponatremia were classified as hyponatremia group , and the other 23 patients without hyponatremia were classified as control group .Ten factors were included in the univariate analysis: age, gender, the highest level of CSCI , the degree of CSCI , the blood albumin when transferred to ICU , the serum sodium when transferred to ICU , the use of glucocorticoid , the incidence of neurogenic shock , the average daily urine output , and the average daily liquid balance .The variables with significance (P<0.05) in the univariate analysis then entered stepwise logistic regression analysis .The optimal critical point of the continuous variables with statistical significance in the univariate analysis was determined by drawing the receiver operator characteristic curve . Results There were differences in two variables between the two groups ( P<0.05 ) .The incidence of neurogenic shock before the occurrence of hyponatremia was 57.7% ( 15/26 ) in the patients with hyponatremia and 26.1% ( 6/23 ) in the patients without hyponatremia(χ2 =6.516,P=0.011).The average daily urine output was (2225 ±389) ml in the patients with hyponatremia and (1936 ±289) ml in the patients without hyponatremia (t=2.924,P=0.005).The stepwise logistic regression analysis indicated that these two factors may be the independent relevant factors (OR =13.708 and 0.996, P =0.004 and 0.002, respectively).The receiver operator characteristic curve demonstrated the average daily urine output more than 2331 ml was the optimal critical point . Conclusion The neurogenic shock and the average daily urine volume more than 2331 ml are the independent relevant factors of early stage hyponatremia in patients with complete CSCI .

Objective To explore the immuniated function of infants with bronchiolitis. Methods In vitro production of IL-18,12, 10, 4, IFN-? by peripheral blood mononuclear cells (PBMC) and plasma IgE of bronchiolitis infants measured by enzyme-linked im-munosorbent assay, expression of lymphocyte activation gene - 3 (LAG - 3) mRNA from PBMC measured by semi - quantitative RT- PCR.Forteen healthy children were as normal control. Results Compared with normal control, IL - 12 (390. 94 ? 95. 88 vs 452.44?195.07) ng/L and IL-18(146.23? 55. 81 vs 246.69?121.29) ng/L activity were significantly decreased (P0.05) ;The levels of IL-4(30. 52 ? 17. 65 vs 16.20? 8.94) ng/L and IL-10 (302. 40 ? 100.04 vs 195.30? 84.01) ng/L were elevated significantly(P

Objective To study the optimal timing of tracheotomy in patients with acute cervical spinal cord injury who need ventilation for a long time . Methods A retrospective research on seventy-nine patients with acute cervical spinal cord injury who underwent tracheostomy in our hospital from January 2011 to December 2015 was conducted .The 79 patients were divided into two groups.The patients with a duration from intubation to tracheostomy less than or equal to 10 days were enrolled in group A , and the duration more than 10 days, group B.The duration of ventilation , the length of ICU stay , and the incidence rate of lung infection were compared between the two groups . Results The duration of ventilation in the group A (192 ±58) h was less than that in the group B (348 ±53) h (t=-12.490, P=0.000).The length of ICU stay in the group A (9.8 ±2.7) d was less than that in the group B (15.9 ±2.2) d (t=-11.058, P=0.000).The incidence of pneumonia in the group A (16.2%, 6/37) was lower than that in the group B (38.1%, 16/42,χ2 =4.686, P=0.030).Mechanical ventilation was successfully withdrawn in 34 and 38 cases of group A and B, without significant difference (χ2 =0.000, P=1.000). Conclusion Early tracheostomy in patients with acute cervical spinal cord injury who need ventilation for a long time could shorten the duration of ventilation and the length of ICU stay , and decrease the incidence of pneumonia .

Objective To collect the main contents of research in critical care medicine in foreign countries with the purpose of providing references for domestic research. Methods A two-way clustering analysis of foreign literature in PubMed concerning critical care medicine was conducted from 2004 to 2015 in this study, and the subjects of greatest interest were collected through the information visualization analysis pathway. Results Eight areas of most popular interest critical care medicine from January 1st, 2004 to November 8th, 2015 were found: blood sugar control in intensive care unit (ICU), acute kidney injury (AKI) and renal replacement therapy (RRT), nutritional support, the impact of ICU practice on reducing mortality, the assessment of critical patients, study of antibiotic resistance, the assessment of the life quality of critically ill patients, and home care and the rehabilitation of critically ill patients. According to the related literature, research in the field of critical care medicine has been growing steadily. USA, Japan, and Europe are the most developed countries or area in the field of critical care medicine. The four major research networks concerning research in critical care medicine were found: the control of blood glucose, monitor of circulatory function, nutritional support, and studies on AKI. Conclusion The most popular topics in research concerning critical care medicine research from 2004 to 2015 were blood glucose control, monitoring of circulatory function, nutritional support and AKI.

Objective To evaluate operative efficacy in regional pancreaticoduodenectomy with mesenteric-portal vein resection and graft reconstruction using iuternal jugular vein for pancreatic head carcinoma.Methods From Jan 2000 to Jan 2003,6 patients with pancreatic head tumors and mesenteric- portal vein involvement underwent regional pancreatieoduodenectomy with mesenteric-portal vein reseetion and vascular reconstruction using internal jugular vein.Results Surgery was successful in all 6 patients. Postoperative pathology revealed that mesenteric vein or portal vein were invaded by tumor in all cases. Survival time ranged from 17 to 49 mouths.The median survival was 23.4 months.Two cases have survived over 3 years and one of them was alive 49 months postoperatively without recurrence.Conclusion The regional pancreaticoduodenectomy with tumor invaded mesenteric-portal vein resection and graft reconstruction by using internal jugular vein renders a longer survival in metastasis-negative patients of pancreatic head adenocarcinoma.

ObjectiveTo analyze literature on acupuncture-related adverse events published in periodicals in Science Citation Index (SCI) and Medllars Online(Medline).MethodsWe searched the Web of Science database and the Medline database to identify articles about the safety of acupuncture therapy.Case reports,case series,surveys and other observational studies were included if they reported factual data,but review articles,translations and clinical trials were excluded.ResultsFindings:The inclusion criteria were met by 232 articles that in total reported on 389 cases of adverse events after acupuncture.Conclusion Acupuncture therapy is relatively safe,most acupuncture-related adverse events can be avoided by standardized clinical practice.Establishment of acupuncture medical safety standard system is extremely urgent.

Objective To explore the effects of electroacupuncture on the expression of glucose transporter 4 (GLUT4) and protein kinase Bβ (Akt2) in the skeletal muscles of insulin-resistant (IR) rats. Methods Twentyfour male Wistar rats were randomly divided into a normal control group, a model group and an electroacupuncture (EA) group. The rats of the model group and the EA group were fed with high fat diets to establish a model of insulin resistance. The rats in the EA group were then treated with electroacupuncture for 2 weeks, while those in the model group were not. Blood samples were collected to evaluate fasting insulin (FINS) and fasting blood glucose (FBG) to calculate the insulin sensitivity index (ISI). GLUT4 and Akt2 mRNA in the skeletal muscles were determined with reverse transcription-polymerase chain reactions (RT-PCRs) after 2 weeks of EA treatment. Results Compared with the control group, the FINS in the model group increased significantly, and ISI decreased significantly. Compared with the model group, the FINS in the EA group decreased significantly and ISI increased significantly. The expression of GLUT4 and Akt2 mRNA in the model group was significantly lower than in the control group or the EA group. Conclusion Electroacupuncture might improve the condition of IR rats, probably by enhancing the transposition of GLUT4 in the phosphatidylinositol 3-kinase/protein kinase signaling pathway.

Acupuncture Therapy ; adverse effects ; Humans