Objective To explore the clinical manifestation and laboratory examination of chronic diarrhea in children with acquired immunodeficiency syndrome(AIDS) and analyze the reasons that causes the chronic diarrhea in children.Methods Clinical data of 7 patients (male 4 cases,famale 3 cases)with AIDS with manifestation of chronic diarrhea among the 17 cases were diagnosed as AIDS in Beijing children′s hospital from Jan.1999 to Dec.2006.The time of diarrhea,degree of dinrrhea,characteristic of stool,accompaniment symptom,laboratory examination were retrospectively analyzed.Results The average onset age was 6 years old(from 2-9 years old).The average time of diarrhea was 6 months(from 1-16 months).Four cases main complained with chronic diarrhea,3 cases came to the hospital because of fever,cough and wasting;6 cases with diarrhea,7 cases with malnutrition and anemia,5 cases accompanied hypokalemia and metabolic acidosis,6 cases had delay in growth and development,2 cases with abnormal stool routine exam,1 case with positive stool culture of fungi.All patients were with lower CD4,5 cases with lower CD4/CD8.Conclusions Chronic diarrhea is a common symptom in children with AIDS,and usually accompanied by obvious delay in growth and development,malnutrition and anemia,the reasons that causes the chronic diarrhea are consi-dered to be related with both the opportunistic infection and HIV infection.

Objective:To investigate the effect and mechanism of lysine acetyltransferase 5(KAT5) on the radio-sensitivity of anaplastic thyroid carcinoma (ATC).Methods:The expression levels of endogenous KAT5 in ATC and normal thyroid cells were detected by Western blot and qRT-PCR. The effect of KAT5 specific inhibitor NU9056 on the radio-sensitivity of human ATC cells and normal thyroid cells was evaluated by colony formation assay. TCGA database, JASPAR database, along with Western blot, microRNA sequencing, qRT-PCR and dual-luciferase reporter assay were conducted to unravel the underlying mechanism.Results:The expression of endogenous KAT5 at the protein and mRNA levels in human ATC cells was significantly higher than that in normal thyroid cells. NU9056 could significantly enhance the radiosensitivity of human ATC cells to 8505C and CAL-62, whereas showed no sensitization effect on normal thyroid cell Nthy-ori 3-1. Knockdown of KAT5 and NU9056 both down-regulated the expression level of miR-210 in the TC cells, while NU9056 decreased the expression level of transcription factor c-Myc. The putative binding sites of c-Myc in the miR-210 promoter region were predicted, and transfection of c-Myc plasmid significantly enhanced the luciferase activity of miR-210 promoter. Elevated miR-210 level was associated with worse survival of patients with thyroid carcinoma. Down-regulated expression of miR-210 decreased the TET2 mRNA level, while inhibition of miR-210 increased the TET2 mRNA level.Conclusion:The aberrantly-activated KAT5/miR-210/TET2 pathway probably causes the radioresistance of ATC, becoming a novel sensitizing target for ATC radiotherapy in clinical practice.

Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Objective To preliminarily investigate curative effect of hepatic arterial perfusion of p53 gene in the therapy of advanced hepatocellular carcinoma.Methods Tirty cases of advanced hepatocellular carcinoma were divided into experimental group and control group,p53 gene was perfused into target artery confirmed by angiography.In experimental group,10~(12)Vp of p53 gene and 20 mg OPT were employed every week as a course for 21 days and 1 to 4 courses time the cases of the study.In control group,only 20 mg OPT was used.Results The survival period was 14 to 405 days in experimental group and 18 to 167 days in control group.There was a significant difference between the two groups(P＜0.05). Conclusion p53 gene is efficacious in the therapy of advanced hepatocellular carcinoma.(J Intervent Radiol,2007,16:127-129)

Child ; Community-Acquired Infections ; microbiology ; Humans ; Pneumonia, Bacterial ; microbiology

Increasing the production and secretion of endogenous opioid peptide by immune cell can significantly induce myocardial protective effects against ischemia-reperfusion injury. Gene therapy is promising to increase endogenous enkephalin (ENK). However, classical viral and plasmid vectors for gene delivery are hampered by immunogenicity, gene recombination, oncogene activation, the production of antibacterial antibody and changes in physiological gene expression. Minimalistic immunologically defined gene expression (MIDGE) can overcome all the deficients of viral and plasmid vectors. The exon of rat's preproenkephalin (PPENK) gene was amplified by PCR and the fragments were cloned into pEGFP-N1 plasmids. The recombined plasmids were digested with enzymes to obtain a linear vector contained promoter, preproenkephalin gene, RNA stable sequences and oligodesoxy nucleotides (ODNs) added to both ends of the gene vector to protect gene vector from exonuclease degradation. A nuclear localization sequence (NLS) was attached to an ODN to ensure the effective transport to the nucleus and transgene expression. Flow cytometry, laser confocal microscopy and Western blotting demonstrated that PPENK-MIDGE-NLS can transfect leukocyte of rat in vivo, increase the expression of proenkephalin (PENK) in tissue, and the transfection efficiency depends on gene vector's dosage. These results indicate that PPENK-MIDGE-NLS could be an innovative method to protect and treatment of myocardial ischemia-reperfusion injury.
Animals ; Cloning, Molecular ; Enkephalins ; genetics ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Leukocytes ; Plasmids ; Promoter Regions, Genetic ; Protein Precursors ; genetics ; Rats ; Transfection ; Transgenes

OBJECTIVE:To study the effects of goserelin on vascular growth factor and immune function of rats with prostatic hyperplasia. METHODS:Rats were selected to establish prostatic hyperplasia model and randomly divided into model group,gose-relin low-dose,medium-dose and high-dose groups (0.4,0.8,1.2 mg/kg);normal rats were selected as normal control group, with 10 rats in each group. Normal control group and model group were given normal saline intragastrically,and goserelin groups were given relevant dose of drugs intragastrically,once a day,for consecutive 25 days. The prostate volume,wet weight,prostatic index of rats were detected as well as positive cell area of VEGF,TGF-β1,FGF,CD4 and CD8 in prostate tissue. RESULTS:Compared with normal control group,prostate volume,wet weight,prostatic index,positive cell area of VEGF,TGF-β1,FGF, CD4 and CD8 were all increased in model group (P<0.05). Compared with model group,the above indexes of goserelin groups were all improved (P<0.05),especially those in medium-dose and high-dose groups were better than in low-dose group (P<0.05);there was no statistical significance between medium-dose group and high-dose group(P>0.05). CONCLUSIONS:Gosere-lin can relieve prostatic hyperplasia of rats,reduce the expression of VEGF in prostate tissue and regulate immune function.

Objective To investigate the expression of CD14/CD16 by monocytes and the anti-inflammatory effects of hypertonic saline plus dextran (HSD) in adult blunt trauma patients in hemonhagic shock. Method A total of 30 adult patients were eligible for inclusion in the study if they sustained blunt trauma from March to October 2007 and had at least one recorded episode of hypotension (systolic blood pressure ≤ 90 mm Hg) with clear evidence of blood loss (external or internal including the thorax, abdomen or retroperitoneum). Patients were excluded if they refused to participate, were admitted ≥ 6 hours after injury, were pregnant, or had chronic disease. The enrolled patients were randomly divided in a double-blinded manner into an HSD group which was administered 7.5% Nad plus 6% dextran - 70, and a control group which was administered 0.9% NaCl. A single 250 ml dose of either HSD or NaO was immediately administered to the patients in each of the two groups while they were in the emergency room. The primary outcomes were to measure the changes in CD4/CD16 expression by monocytes and the levels of anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-lra and IL-10. Patient demographics, fluid requirements, organ dysfunction, infection and death were recorded. Results A total of 28 patients were enrolled with no significant differences in their clinical measurements. Hyperosmolarity was modest and transient. HSD altered the shock-induced monocyte redistribution pattern by reducing the drop in the "classic" CD14 ++ subset and remarkably affecting the expansion of the "pro-inflammatory" CD14+CD16+ subsets. In parallel, HSD significamly reduced pro-inflammatory TNF-α production while increasing anti-inflammatory IL-lra and IL-10 production. Conclusions This human trial demonstrates that HSD has anti-inflammatory and immunologic properties for trauma patients in hemorrhagic shock. HSD exerts profound immunomodulatory effects, promoting more balanced pro-/anti-inflammatory responses and reducing post-traumatic complications. Therefore, it could be useful in attenuating post-trauma multiorgan dysfunction (MOD).

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 analyze the safety, feasibility and operative technique details of non-grasping en bloc mediastinal lymph nodes dissection technique in uniportal video-assisted thoracic surgery(VATS) for lung cancer.Methods From April, 2014 to March, 2015,46 patients with lung cancer received non-grasping en bloc mediastinal lymph nodes dissection after uniportal VATS lobectomy.Clinical data of the cases were analyzed retrospectively.There were 19 males and 27 females.The age was(57.2 ± 9.0) (38-73) years.The first 6 cases were performed in the lateral decubitus position while the later 40 cases were all performed in the semiprone position.Results All cases accepted uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection successfully.Arm fatigue of surgeon and assistant was obviously relieved when the patient was placed in the semiprone position.The thoracic drainage time was(3.2 ± 2.1) (1-12)days and the postoperative length of hospital-stay was(6.0 ± 4.5) (2-27) days.The number of dissected mediastinal lymph nodes stations was (4.3 ± 0.8) (3-6)and the number of dissected mediastinal lymph nodes was (11.8 ± 4.9) (4-30).There were 42 cases with stage No , lease wit stage N1, and 3 cases with stage N2 in pathological examination.Five patients developed minor postoperative complications.No perioperative death occurred.Conclusion Uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection for lung cancer was safe and feasible, which could decrease the interference of the instruments and help to keep the surgical field clear.Non-grasping en bloc mediastinal lymph nodes dissection would be performed more smoothly in the semiprone position with less damage to lung and better ergonomics.