Dystonia is common in children with cerebral palsy. It can cause motor dysfunction, and is frequently associated with altered speech articulation, abnormal swallowing, and excessive drooling. Although trihexyphenidyl (Artane) is an anticholinergic agent with a long history of use in the management of dystonia in adults, information is limited regarding the use of trihexyphenidyl in children. This study reviewed the clinical experience of the use of trihexyphenidyl in children with cerebral palsy for dystonia, with special emphasis on benefits and tolerability.

Antigens, Neoplasm ; immunology ; Cancer Vaccines ; therapeutic use ; Dendritic Cells ; immunology ; Humans ; Immunotherapy ; methods ; Liver Neoplasms ; therapy

Trypsin was purified from crude material of pig pancreas by AOT/isooctane reversed micellar system.The influence of the main operating parameters such as ethanol concentration in forward and backward extraction,pH,KCl and AOT concentration,temperature were investigated.Forward and backward extraction recovery of trypsin reached almost 90% and neared 100%,respectively.Finally,about 88% of total yield was obtained,and the specific activity of trypsin was increased to over 1800U/mg with purification factor of 5 folds more.In AOT-isooctane reverse micellar extraction system,denaturation or precipitation of proteins always occured due to strong electrostatic interaction between AOT-proteins molecules.It had been resolved by adding ethanol into reverse micellar system,and no denaturation was observed.Otherwise,the phase separation time was shortened significantly because of ethanol added.It was only 10 minutes or less to reach phases separation after forward and backward extraction.If this method can be applied in industry,efficiency will be greatly improved.

The purification of kallikrein using CTAB/hexanol/octane reverse micelles extraction has been studied and optimized,under various aqueous pH values, ionic strength and species, CTAB concentration and co-surfactant concentration. The result shows that the extraction efficiency approaches 100%, and the activity recovery is more than 80%, the commercial enzyme specific activity is increased by 1.97 times and the crude enzyme activity is increased by 7.15 times, which from 31U/mg to 219U/mg,under the conditions of[CTAB]=0.02 mol/L, hexanol/octane (V/V)=1∶5, pH=9.0 and[KBr]=0.1 mol/L in forward extraction, pH=7.0 ,[KBr]=1.5 mol/L and 15% ethanol(V/V) in backward extraction. The result of purified kallikrein is examined by the SDS-PAGE analysis. Reverse micelles extraction is a potential technique for the application in the downstream biotechnological processes.

Objective To explore the prenatal ultrasonographic features of fetuses diagnosed as echogenic bowel and chromosomal abnormalities. Methods From September 2009 to June 2013, eighty cases diagnosed as echogenic bowel by prenatal ultrasound screening in our hospitals underwent chromosomal karyotype analysis and were followed up till fetal birth. The prenatal ultrasonographic features were carefully correlated with the postnatal findings. Results Prenatal ultrasoundand chromosomal findings of the 80 cases were:(1) Fifty-eight cases of fetuses with echogenic bowel alone (72.5%, 58/80, without chromosomal karyotype abnormalities). (2) Eleven cases of fetuses with additional ultrasound soft markers (13.8%, 11/80, without chromosomal karyotype abnormalities). The ultrasound examination revealed 8 cases of choroid plexus cysts, 1 case of single umbilical artery, 1 case of shorter nasal bone, and 1 case of echogenic intracardiac focus. (3) Five cases of fetuses with severe functional abnormalities or complex structural malformations and normal chromosomal karyotype. The ultrasound examination revealed 3 cases of structural cardiac malformations, 1 case of heart failure and 2 cases of central nervous system malformations. Of them,one case showed complex malformations (right ventricular dysplasia syndrome, cerebellar dysplasia and single umbilical artery), whereas the remaining 4 cases only involve single malformation. (4)Six cases had chromosomal abnormalities (7.5%, 6/80), including 3 cases of abnormal chromosome microdeletions, and 3 cases of abnormal chromosome numbers (1 21-trisomy syndrome, 1 18-trisomy syndrome, and 1 triploid syndrome). All of them had severe structural malformations and abnormal soft markers. The ultrasound examination revealed 2 cases of severe cardiac malformations, 2 cases of central nervous system malformations, 1 case of pericardial/peritoneal effusion, and 1 case of placental chorionic multiple hemangioma. One case of holoprosencephaly (donor of the twins) ended with intrauterine death. The associated abnormal soft markers include nuchal fold (NF) thickening, choroid plexus cysts, umbilical cord cysts, single umbilical artery, and placental chorionic hemangioma. Conclusions The fetuses with echogenic bowelaloneusualyhaveagoodprognosis.Insomecases,echogenicbowelmaydisappearduringvfolow-up.The fetuses complicated with severe structural malformations and chromosomal abnormalities have poor prognosis. For the fetuses diagnosed of echogenic bowel by prenatal ultrasound screening, systematic ultrasound examination should be carried out and clinical chromosomal karyotype analysis was suggested.

? AlM: To analyze the incidence, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy ( PPV) .
?METHODS: Totally, 146 patients (146 eyes) undergone PPV in our hospital were selected. Age, gender, eye, course and operation time of patients were compared, in order to understand the incidence rate and characteristics of high intraocular pressure. Primary diseases, intraoperative treatment methods and intraocular tamponade type were compare, in order to analyze the related risk factors of high intraocular pressure.
? RESULTS: Forty - seven patients occurred high intraocular pressure after operation, the incidence rate was 32. 2%. There was no significant difference in age, gender, eye, course and operation time (P>0. 05). The incidence rate in diabetic patients with simple vitreous hemorrhage and with tractional retinal detachment were 21.1% and 57.6%, respectively (P<0.05). The incidence rate in retinal detachment with PVR below grade C2 and above C2 were 19. 0% and 43. 8%, respectively (P<0. 05). The incidence rate in ocular trauma with vitreous hemorrhage and with intraocular foreign bodies were 25. 0% and 70. 0%, respectively (P<0. 05). The incidence rate of patients treated with panretinal photocoagulation was 50. 8%, significantly higher than patients without treated with panretinal photocoagulation (P<0. 05). The incidence rate of patients treated with part panretinal photocoagulation was 29. 5%, higher than patients without treated with panretinal photocoagulation, but there was no statistical difference ( P > 0. 05 ). The incidence rate of using silicone oil, C3 F8 and simple ventilation were 59. 7%, 34. 5% and 14. 5%, respectively (P<0. 05).
? CONCLUSlON: After vitrectomy intraocular hypertension incidence and preoperative, intraoperative treatment of primary disease is closely related to factors such as the way and intraocular tamponade.

AIM: To investigate whether Programmed death-1 (PD-1) expression on peripheral CD4~+CD25~(nt/hi)CD127~(lo) regulatory T cells (Treg) was associated with disease progression in HIV-1-infected patients. METHODS: Peripheral blood from 108 HIV-1-infected patients in distinct disease progression statuses and 27 healthy individuals were collected in the present investigation. PBMCs were isolated by centrifugation on Ficoll-Hypaque, followed by staining with anti-CD4-PerCP, anti-CD25-FITC, anti-CD127-PE and anti-PD-1-APC. PD-1 expression on Treg was analyzed by four-color staining flow cytometry. CD4~+T cell absolute counts were determined using Multitest CD3/CD4/CD8/CD45 kit and plasma viral loads were detected on NucliSens EasyQ. All data were analyzed using SPSS14.0 software. RESULTS: In peripheral blood of healthy individuals, Treg expressed PD-1 at very low levels (1.72%±0.65%). In contrast, Treg from HIV-1-infected patients showed a significantly increased PD-1 expression (5.33%±2.24%, P<0.01). Moreover, AIDS patients exhibited statistically higher PD-1 expression on Treg (7.87%±2.23%) than newly HIV-1 infected patients (3.22%±1.01%, P<0.05) and patients in progression to AIDS(5.21%±1.72%, P<0.05). PD-1 up-regulation on Treg was closely correlated with reduced CD4~+T cell absolute counts but elevated plasma viral load. CONCLUSION: Overall, we found that PD-1 expression on peripheral Treg was up-regulated and correlated with disease progression in HIV-1-infected patients for the first time. These findings not only extend our understanding of how Treg functions in HIV-1-infected patients but also support the notion that blocking PD-1/PD-L1 interactions may represent a potential therapeutic strategy for HIV-1-infected patients.

Objective To investigate the clinical characteristics and currently treatment status of intractable ulcerative colitis (IUC). Methods A retrospective analysis was conducted on the data of inflammatory bowel disease patients, who were hospitalized in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from January 1999 to December 2009. According to the reaction to glucosteroids (GCS) treatment, they were divided into GCS effective group and intractable group. The general data, lesion, clinical symptoms and laboratory findings of these two groups were compared.Further treatments and the results of intractable group were analyzed. Results Totally 234 UC patients were enrolled, of which 37.6％ (88/234) patients received GCS treatment, intractable group and effective group took up 23.9％ (21/88) and 76.1％ (67/88) respectively. There was no significant difference of lesion between two groups (P＞0.05). Compared with effective group, the proportion of intractable group was higher in moderately severe bellyache[38. 1 ％ (8/21) vs 13. 4％ (9/67), P＝0.012, OR＝3.97, 95％CI:1.29～12.23], anemia[61.9％(13/21) vs 32.8％(22/67), P＝0.018,OR＝3.32, 95％CI:1.20～9.20], thrombocytosis[57.1％(12/21) vs 29.9％(20/67), P＝0.023,OR＝3.13, 95％ CI: 1.14 ～8.61]and hypoalbuminemia[38.1 ％ (8/21) vs 11.9％ (8/67), P＝0.007, OR＝4.54, 95％CI: 1.44～ 14.32]. Some patients of intractable group could be remission through extending period of GCS treatment, adding the immunomodulators or biological agents and intestinal segment excision. Conclusion UC patients with moderately severe bellyache, anemia,thrombocytosis, hypoalbuminemia at the onset of disease, which may indicate relatively poor response to GCS treatment. Immunomodulators, biological agents and surgery are the further treatment for IUC patients.

Recent studies indicate that the activation of peroxisome proliferator-activated receptor gamma (PPARγ) can inhibit the invasion and metastasis of hepatocellular carcinoma (HCC) by inhibiting proliferation and adhesion of HCC cells,degradation of extracellular matrix and angiogenesis.Therefore,the mechanisms that PPARγsignaling pathway inhibits the invasion and metastasis of HCC may provide help for the clinical treatment,and is expected to improve the survival rate of HCC patient.

The structure of social network and its information spreading characteristics in 41 users of Sina microb-logs were studied , which showed that the exchange level was quite low in the 41 users of health information in Sina microblogs, usually in small groups.Although the 41 users were found in the core area, their exchange was sporadic even with no exchange in the core nodes or in other nodes, thus effective information sharing could not be achieved and information could not be widely spread .