Bruton tyrosine kinase (Btk) is a member of the non-receptor protein tyrosine kinases of Tec family.It plays an important role in growth,proliferation,differentiation and signal transduction of B lymphocyte.After activation of B-cell receptor (BCR) by diverse stimuli,Btk is activated through tyrosine phosphorylation.Activated Btk can stimulate several downstream signaling proteins.Btk and BCR signaling pathways play important roles in initiation and maintenance of B cell malignancies.This review focuses on the recent findings in association of Btk and B cell malignancies.

Objective To investigate the immune disorder in elderly patients with severe ischemic stroke and to explore whether a new type of diabetes-specific enteral nutrition formula can regulate the immune function of these patients.Methods In the randomized controlled prospective study,90 patients aged 60-80 years with acute ischemic stroke and NIHSS score more than 10 and dysphagia were randomized to two groups:receiving a new type(Group A) of,versus traditional(Group B) diabetes-specific enteral nutrition.30 Patients aged 60-80 years with acute ischemic stroke and NIHSS score ≥10 without dysphagia were enrolled as control(Group C).The immune function was observed,and the nutritional status and immunological function were compared between two different enteral nutrition groups at 7 days of treatment.Results After 7 day follow-up,the serum lipid stats significantly ameliorated in group A.An obvious suppression of immune state was observed in severe acute ischemic patients at onset of 7 days.At day 7 of treatment,the percentage of CD3+ T cells in group A was(69.25±9.93)％ after treatment vs.(63.36±7.79)％ at baseline(P＜0.001),and CD3 +CD4+T cells was(45.79±9.47)％ after treatment vs.(36.12±9.15)％ at baseline(P＜0.001),as well as CD4+/CD8+ cells were(2.27±1.40)％ after treatment vs.(1.70±0.82)％ at baseline(P=0.001).At 7 days of treatment,the percentage of CD3+ T cells was higher in group A (69.25 ±9.93) ％ than in group B(63.07± 9.47) ％ (P＜0.001),and the percentage of CD3 + CD4 cells was higher in group A(45.79 ± 9.47) ％ than in group B(41.32 ± 8.89) ％ (P=0.024).Conclusions Enteral nutrition preparations can provide sufficient energy support in the acute ischemic stroke.Immunosuppressive state exists in patients with acute phase of severe ischemic stroke.The new type of diabetic enteral nutrition formula can significantly improve immunosuppressive state in patients with acute severe stroke.

Objective To assess the public health service quality objectively in Shenzhen,and promote the equity of basic public health services.Methods The criterion and method of the assessment were established by municipal health administrative department,the assessment of institutions and regions were conducted by experts selected by municipal professional institutions.Regional assessment was the comprehensive evaluation of public health service qualities of professional public health institutions,medical institutions and the community health centers.The assessment of the degree of public health service quality satisfaction was accomplished by a third-party institution.Results The accomplishment ratio of indicators for public health service quality was 93.2％.This ratio has witnessed a high increase with mental health institutions,occupational disease prevention and control institutions and health education institutions on one hand.On the other,it has dropped with institutions of disease control,chronic disease control and medical institutions within the region.On the whole,this ratio has increased with all the districts to different extents.Despite the overall improvement of public health capabilities citywide,imbalances are found among districts and institutions as well.Conclusion It is imperative to further improve the public health service system and equity while carrying out specific tasks in this respect.

Female ; Humans ; Infant, Newborn ; Kidney Neoplasms ; Twins, Monozygotic ; Wilms Tumor

Objective To investigate the protective effects of ambroxol on lung during perioperation in elderly patients with myasthenia gravis.Methods 58 elderly patients diagnosed as myasthenia gravis combined with thymic disease were divided into treatment group and control group randomly.During the perioperation,the treatment group was treated with ambroxol,while the control group was not.Comparative analysis of pulmonary complications,pulmonary ventilation indexes,blood gas indexes,and serum concentration of C-reactive protein (CRP),tumor necrosis factor-α (TNF-α),interleukin 1β (IL-1β) and IL-10 was performed.Results The incidence rate of postoperative pulmonary complications (pulmonary atelectasis,pneumonia and bronchitis) was significantly lower in the treatment group in the control group (9.4％ vs 15.6％,P＜0.05).Peak inspiratory pressure (PIP) and resistance of air way (RAW) were lower in treatment group than in control group [(22.32±3.43) cmH2O vs (26.54±4.81) cmH2O,(29.17±5.74) cmH2O· L-1s-1vs (34.47±7.94) cmH2O · L-1 · s-1 both P＜0.05],while compliance of lung (CL) washigher in treatment group than in control group [(106.04±-14.73)ml/cmH2O vs (95.11±9.50) ml/cmH2O,P＜0.05].Two days after operation,PaO2,SaO2 and PaO2/FiO2 were significantly higher in treatment group than in control group [(89.66 ±13.23) mmHg vs (70.94±12.75) mmHg,(96.95±2.65)％ vs (89.44±2.78)％,(219.47±54.05)mmHg vs (187.38±37.72) mmHg,respectively,all P＜0.05].Serum concentration of CRP,TNF-α,IL-1β were lower and serum level of IL-10 was higher in treatment group than in control group [(29.37 ± 14.87)mg/L vs (43.94 ±21.42) mg/L,(35.55±4.74)μg/L vs.(52.80±6.63) μg/L,(17.06±6.85)μg/L vs.(28.62±7.72) μg/L],[(132.84± 12.91)μg/L vs.(87.18± 16.37)μg/L,respectively,all P＜0.05].Conclusions Ambroxol hydrochloride can effectively reduce the incidence rate of postoperative pulmonary complications after thymectomy,improve the pulmonary ventilation function,and inhibit the inflammatory reaction in elderly patients with myasthenia gravis,which is worthy of wide application in the perioperation.

Objective To evaluate the gender differences in neuromuscular blockade induced with rocuronium in patients undergoing abdominal surgery. Methods Twenty-four ASA Ⅰ or Ⅱ patients aged 20-59 yrs undergoing abdominal surgery under general anesthesia were enrolled in this study. Their body mass index (BMI) ranged between 18.5-25 kg?m-2. Patients with neuromuscular disease were excluded and no patient was taking any drug that might influence the effect of muscle relaxant. The patients were divided into male group ( n = 12) and female group (n = 12). The neuromuscular function was monitored and recorded using accelerography (DK-5210, Biometer, Denmark). The response of adductor pollicis muscle to train-of-four (TOF) stimulation of ulnar nerve were recorded. Body temperature was maintained at 36.0-36.9℃ and room temperature at 24-26℃ during surgery. The premedication included intramuscular atropine 0.01 mg?kg-1 and oral diazepam 10 mg. Anesthesia was induced with fentanyl 2-4 ?g?kg-1, propofol 2-3 mg?kg-1 and rocuronium 0.6 mg?kg-1. The patients were intubated and mechanically ventilated (VT = 7-10 ml RR = 12-14 bpm). PET CO2 was maintained between 35-45 mm Hg. Anesthesia was maintained with propofol by TCI (effect-site concentration was set at 3-4 ?g?ml-1) and intermittent i.v. boluses of fentanyl. Rocuronium (1 mg?ml-1) was infused and T1 was maintained at 5%-10% of the control height. At the end of surgery rocuronium infusion was terminated and neostigmine 0.05 mg?kg-1 was given i.v. .Results There were significant differences in body weight and height between male and female groups ( P

The progressive injury of retinal ganglion cells ( RGCs) is a common occurrence in several eye diseases, which ultimately may lead to irreversible blindness. Currently, there are still no effective or ideal treatments for it in practice, however some recent studies show that stem cell transplantation may provide a promising new idea for neuroprotection and replacement of retinal ganglion cells. This paper will review the research progress of stem cell transplantation-based treatment.

Objective To analyze the clinical characteristic s of an infant with congenital lipoid adrenal hyperplasia (CLAH),and to sequence the acute regulatory protein (steroid acute regulatory,StAR) gene of the infant patient and her pedigree.Methods Physical examination,laboratory tests,and imaging examination of the 11-month-old patient with CLAH were collected.DNA was extracted from blood samples of the patient and her parents.The 7 exons of StAR gene were amplified by PCR and then sequenced.Results Dark skin,girl vulva,and one each 1.0 cm×1.0 cm palpable lump in inguinal area bilaterally were observed.The adrenocorticotropic hormone (ACTH) was 253 pg/ml,cortisol was 27.6 nmol/L at 8 am,17-hydroxyprogesterone was 3 nmol/L.Uhrasound showed that sign of testicular ultrasonography existed in bilateral inguinal regions.Karyotype analysis showed 46,XY.Sequencing of PCR amplified fragments showed that there were two heterozygous mutations c.229C ＞ T,p (Gln77X) and C.659A＞G,p (His220Arg) of StAR gene in this patient.By rectifying the disturbance of electrolyte,and treating with hydrocortisone and 9α fludrocortisone,etc,the patient has been stable so far.Conclusion The patient presents typical clinical manifestations.Two heterozygous mutations including c.229C ＞T,p (Gln77X) from maternal and C.659A＞G,p (His220Arg) from paternal of StAR gene were detected.Wherein the c.659A＞G,p.(His220Arg) as a novel point mutation of StAR gene,has not been reported so far.

Covered in the paper are concepts and contents of medical risk and emergency response technology.Based on a description of medical risk information management experiences in Japan,Sweden and the United States and the current studies of medical risk response information management,the paper proposed measures for China in medical risk information emergency technology.Recommendations made include establishing a comprehensive emergency medical risk information management system,scientific medical risk information collection,monitoring,assessment,early warning systems,as well as building an intelligent risk emergency information decision system and establishing medical risk communication channels,thereby preventing effectively the occurrence of medical risks.

ABSTRACT:Objective To investigate whether medial cerebellar nucleus may be involved in the pathogenesis of post-stroke depression (PSD)and explore the pathway that mediates this effect.Methods Healthy SD rats were randomly divided into five groups:control group,stroke group,PSD group,medial cerebellar nucleus (Med)lesion group,and superior cerebellar peduncle (xscp)lesion group.The ethological score of depression was evaluated.The neurotransmitters of Glu and GABA in the lateral hypothalamic area were detected by high performance liquid chromatography.Results Compared with those in control group,the levels of GABA and Glu expressions did not significantly differ in the lateral hypothalamic area in stroke group (P > 0.05 ).In contrast,the levels in PSD group,Med lesion group and xscp lesion group were lower than those in stroke group to different extent (P <0.01). Conclusion These results preliminarily show that medial cerebellar nucleus may participate in the pathogenesis of post-stroke depression,which may be mediated by the cerebellum-hypothalamic pathway.