Child ; Evidence-Based Medicine ; Humans ; Nephrotic Syndrome ; diagnosis ; etiology ; therapy ; Practice Guidelines as Topic ; Recurrence

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

Objective To investigate the clinical significance of ultrasonography in the diagnosis of simple polyhydramnios . Methods 186 singleton pregnancies cases of inpatient and outpatient diagnosed with simple polyhydramnios were divided into three groups with a two-dimensional semi-quantitative method ,separate amniotic fluid index (AFI)> 20cm (A group) ,separate maxi-mum amnionic fluid volume(AFV)>8 cm(B group) ,AFI≥20 cm and AFV≥8 cm(C group) ,and the changes were dynamically monitored .Results Occurrence rates of persistent polyhydramnios and fetal malformations in C group was higher than in the other two groups ,and the difference showed no statistical significance(P<0 .05);No correlation was found between recurrent polyhydr-amnios and fetal malformation among these three groups(P>0 .05);Among the 84 .4% of simple polyhydramnios ,no fetal malfor-mation was found .Conclusion Ultrasound diagnosis of simple polyhydramnios shows clinical value in assessment of fetal malfor-mation ,fetal outcome ,perinatal morbidity and prognosis ,and is good for prenatal counseling and treatment .

Objective To investigate the pathological diagnosis of high-grade intraepithelial neoplasia in gastric biopsy.MethodsOne hundred and forty-three cases diagnosed by gastric biopsy as high-grade intraepithelial neoplasia were analyzed by light microscopy,and were compared with the pathological findings of surgical specimens in 60 cases and a second biopsy in 13 cases.Results Among the sixty cases treated surgically following the gastric biopsies,no carcinoma was found in 6,while the other 54 were diagnosed as gastric adenocarcinoma,27 in advanced stage and 27 in early stage,respectively.Fifteen cases were well-differentiated,24 moderately-differentiated,12 poorly-differentiated and 3 were of mucinous type.Four of the 13 cases with a second biopsy were diagnosed as well-differentiated adenocarcinoma,8 low-grade intraepithelial neoplasia and 1 chronic inflammation.The colorectal adenomas-like changes were morphologically found in 6 surgically-treated cases without carcinoma,5 of whom mucous muscles were not found by biopsy.Fibroblastic reactions were found in 9 cases,all of which were diagnosed as adenocarcinoma in surgical specimens.Conclusion Ninety percent of the cases who are diagnosed as high-grade intraepithelial neoplasia by biopsy may have already been complicated with adenocarcinoma.The location and depth of the specimen in gastric biopsy have a considerable influence on pathological diagnosis.The fibroblastic reaction may be considered as an important marker for gastric adenocarcinoma in pathological diagnosis of gastric biopsy.

Objective To investigate the association of angiotensinogen(AGT)gene A-6G、T174M and G-217A polymorphisms with the risk of essential hypertension(EH)in the elderly of Han nationality.Methods Genotypes of AGT gene A-6G,T174M and G-217A polymorphisms in 177 aged EH patients and 86 sex and age-matched controls were analyzed with gene chip technology.Results The A-6G and T174M polymorphisms of AGT gene were significantly associated with EH.The numbers of the three genotypes of A-6G were 113,58 and 6 in the patient group and 70,15 and 1 in the control group(P= 0.014)and those of T174M were 94,77 and 6,60,25 and 1(P=0.031),respectively.G-217A polymorphism was not related to EH.Individuals carrying A-6G AA and T174M CC genotypes showed 57% and 56% lower risk of EH(OR=0.43;95%CI=0.23-0.82 and OR=0.44;95%CI=0.25-0.79, respectively).Conclusions The A-6G AA and the T174M CC genotype may be related with decreased risk of EH and G-217A polymorphism may have little role in the etiology of EH in Han nationality.

Background More and more attentions are paid to the effect of matrix metalloproteinases (MMPs) in the process of wound healing after excimer laser.Objective The present study was to investigate the effects of GM6001,a matrix metalloproteinases inhibitor,on haze formation after excimer laser epithelial keratomileusis (LASIK).Methods LASEK of -10.00 diopter was bilaterally performed on 27 New Zealand white rabbits and then divided randomly into the GM6001 group,Fluorometholone (FML) group and normal control group.Corneal haze was graded under dim light at 2 weeks,4 weeks and 8 weeks after operation,and the number of eyes in different grades of haze were compared among the three groups.Six corneal samples were harvested in each group for confocal microscope examination at 2,4,8 weeks.The corneal histopathological examination was carried out with the optical microscope,and the ultrastructure of the cornea was examined under the transmission electron microscope.Results The numbers of eyes of different corneal grades of haze at 2,4 or 8 weeks after surgery were significantly different among the three groups (P＜0.05).Compared with the normal control group,the corneal haze grades in the GM6001 group and FML group were apparently lower (P＜0.01),but there was no significant difference in the numbers of eyes of different corneal grades of haze between the GM6001 group and FML group (P＞0.01).The numbers of keratocytes in the GM6001 group were apparently lower than those in the normal control group and FML group in 2,4 or 8 weeks after operation (P＜0.05).No significant difference in the keratocytes was seen between the normal control group and FML group at various time points (P＞0.05).Corneal epithelial cell morphology,disordered arrangement of collagen fibers in GM6001 group and in FML group were less pronounced than in the negative control group.Conclusion GM6001 has an inhibitory effect on the formation of corneal haze after LASEK which suppresses proliferation and production of keratocytye with the similar efficacy as FML.

Objective To study the correlation between cognitive dysfunction and cholinergic neuron changes in basal forebrain(BFB)and brainstem reticular formation(BSRF)areas after brain con- cussion(BC)in rats.Methods Eighty-four Spragne-Dawley rats weighing 250-310g were used.The BC rat models were reproduced by a self-made simple pendulum impact device,then the rats were ran- domized into one control group and six experimental groups(1 day,2 day,4 day,8 day,16 day,and 24 day groups;n=12 in each group).A Morris Water Maze(MWM)test was used to assess learning and memory function of the rats.Cholinergic neurons in the BFB and BSRF were identified with choline acetyltransferase(CHAT)antibody and quantitated.Results Compared with the control group,the la- tency to find the platform in MWM was much longer on days 1-3 after BC,but there was no statistical difference on days 4-21 after BC.The cell number and the ChAT expression activity of cholinergic neu- rons in the BFB were obviously decreased after BC,and reached the lowest level at 8 days after BC,then increased gradually and nearly reached the normal level at 24 days.The ChAT expression activity in BSRF declined on the first 2 days after BC,then went up gradually,and reached the peak at the 24th day.Conclusion The spatial cognition deficit of BC rats can be detected by MWM in the early period (1-3 days after BC).There are significant changes in the number and ChAT expression activity in BFB and BSRF after BC.The change of cholinergic neurons may be correlated with cognitive deficits in BC rats.

BACKGROUND:Hand-foot-mouth disease has become a major public health issue in children in China. In the present prospective study we investigated the clinical characteristics and emergency management of children with severe encephalitis associated with NPE caused by enterovirus 71. METHODS:The study was conducted in 2 pediatric intensive care units (PICUs) over a 2-month period. Clinical records were reviewed of critically ill children with severe encephalitis associated with NPE caused by EV71 who were admitted to PICUs during the period of May to June 2008 in Fuyang. RESULTS:We reviewed the complete records of 36 children, of whom 23 (63.9％) were male and 13 (36.1％) female. Their age ranged from 4 to 48 months, with an average of 15.8 months. Al children except one were under 3 years of age. The overal mortality in these children was 19.4％. The average duration of critical life threatening signs and symptoms was 2.1 days (12 hours-5 days). Nervous system diseases included brainstem encephalitis in 27 children (75％), brainstem encephalitis associated with myelitis in 6 children (16.7％), and general encephalitis in 3 chidren (8.3％), respectively. In 12 patients of NPE (33.3％) pink or bloody bubble sputum and asymmetric pulmonary edema or hemorrhage was the primary manifestation but no typical exanthema was observed. Five children died of acute onset of NPE and / or pulmonary hemorrhage with rapid progression of cardiopulmonary failure within hours after admission. Therapeutic management consisted of mechanical ventilation and administration of mannitol, methylprednisolone, intravenous immunoglobulin (IVIG) and vasoactive drugs, associated with the need of fluid volume resuscitation in 9 (25％) of the 36 children. CONCLUSIONS:In children less than 3 years of age found to be affected by severe EV71 encephalitis associated with NPE, one fifth may die. The major organ systems infected by severe EV71 include the central nervous system, the respiratory system, and the cardiovascular system. Early diagnosis and evaluation, respiratory support, treatment of intracranial hypertension, and mainttenance of function of the cardiovascular system are the most important therapeutic measures.

Biological characteristic of Salvia miltiorrhiza f. alba in field was studied. HPLC method was used to determine the lipophilic constituents (dihydrotanshinone, cryptotanshinone, tanshinone, tanshinone II (A) and miltione) and hydrophilic constituents (salvianolic acid, rosemarinic acid). The results showed that the fresh weight of S. miltiorrhiza f. alba which cropped for 2 years was decreased by 80.47%, while dry weight decreased by 79.42%. The normal diameter of the root was 0.3-0.5 cm, however, the diameter was 0.2-0.4 cm after 2 years, it was said that the decrease of the root diameter was the main reason for the decrease of the yield. The average contents of dihydrotanshinone, cryptotanshinone, tanshinone, tanshinone II (A), miltione, salvianolic acid and rosemarinic acid were decreased by 35.26%, 32.26%, 19.35%, 3.39%, 64.40%, 66.93% in plant which continuously cropped for 2 years, respectively. The yield and active constituents were mostly effected in the plant of S. miltiorrhiza f. alba, which continuously cropped for 2 years.
Drugs, Chinese Herbal ; analysis ; Linear Models ; Quality Control ; Reproducibility of Results ; Salvia miltiorrhiza ; chemistry ; growth & development ; Time Factors

Photo refractive keratectomy (PRK) and laser Situ Keratomileusis (LASIK) have been used for over a decade and become popular in China. Principles and characteristics of eye trackers made by several famous foreign manufacturers are introduced in this paper and their developing direction in the future is pointed out too.
Cornea ; surgery ; Eye Movements ; Humans ; Keratomileusis, Laser In Situ ; instrumentation ; Lasers, Excimer ; Myopia ; surgery ; Photography ; instrumentation ; methods ; Photorefractive Keratectomy ; instrumentation ; Refractive Surgical Procedures ; Video Recording