objective To explore the indication of mechanical ventilation and evaluate the effects of mechanical ventilation with the least delay on the Severe cases of hand-foot-mouth disease(HFMD).Methods Retrospective cohort study was conducted among the severe HFMD cases(n=66)admitted to pediatric intensive care unit(PICU)between July 2008 and september 2009.Sixty-six cases were divided into two groups:42 cases(group A,July 5 to October 31,2008)were ventilated with the common mechanical ventilation,24 cases(group B,April 21 to september 30,2009)were ventilated at least delay when the symptoms of neurogenic pulmonary edema appeared.Then the diffcrences on the survival rate and the mortality in the group A and group B were investigated.Results Twenty out of 42 patients died(47.6%),eighteen were cured(42.6%) and four showed improved signs(9.5%)in group A.Twenty-two out of 24 patients were cured(91.7%),two showed improved signs(8.3%)and no death in group B.The clinical effect of group B was much better tllan group A(P<0.001).Conclusion Early mechanical ventilation would improve the survival rate and decrease the mortality of severe hand-foot-mouth disease.

Objective To explore the clinical features and risk factors of children with severe hand foot and mouth disease (HFMD).Methods The clinical data of 68 children with HFMD associated with brainstem encephalitis were analysed retrospectively from Apr to Sep 2010.Results Among the 68 cases,63cases(92.6％ ) were younger than 3 years.The major symptoms and physical signs of 68 cases included rash (68 cases,100％ ),fever (68 cases,100％ ),fatigue (68 cases,100％ ),irritability (65 cases,95.6％ ),somnolence (42 cases,61.8％ ),vomiting (28 cases,41.2％ ),limb tremor (23 cases,33.8％ ),tendon reflexe hyperactivity (60 cases,88.2％ ),tachypnea or respiratory rhythm abnormality (63 cases,92.6％ ),tachycardia (65 cases,95.6％ ),and hypertension (54 cases,79.4％ ).Twenty-five cases (36.8％,25/68 ) had leucocytosis ( ＞ 12 × 109/L ),and 19 cases ( 27.9％,19/68 ) had hyperglycaemia.X-ray appearances:patchy and pathy shadows in single or bilateral pulmonary were seen in 46 cases( 67.6％,46/68 ).Forty-eight cases were examined by MRI,eight cases displayed ischemic lesions or demyelination.Spinal cord MRI was performed in 3 cases with flaccid paralysis,which showed demyelination.The etiology indicated that 38 cases ( 55.9％,38/68 ) were infected by enterovirus 71,25 cases( 36.8％,25/68 ) were infected by other enterovirus,5 cases (7.3％,5/68) were negative.All the cases were treated by mechanical ventilation with tracheal intubation,in whom 63 cases recovered well,4 cases improved,and 1 case gave up to die.Conclusion Ages ＜ 3 years,enterovirus 71 infection,continual fever,fatigue,somnolence,irdtability,vomiting,limb tremor,tendon reflexes hyperactivity,tachypnea or respiratory rhythm abnormality,tachycardia and hypertension are the high risks of critically ill children associated with severe HFMD.To reduce the fatality rate of HFMD,it is crucial to early judge the high risk factors,and take mechanical ventilations earlier.

Cocrystal separation technology is a technology that utilizes coformers to selectively form cocrystals with target compounds and separate them from mixed systems. Our study used puerarin (PUE), daidzein (DDZ), and genistein (GEN) as model drugs, which have similar structures and are the main isoflavones in Pueraria lobata root. The separation and purification processes in the modern traditional Chinese medicine (TCM) of these three components use conventional column chromatography, recrystallization, and other technologies, which have the issues of lengthy separation cycles, high solvent consumption, and inefficient preparation. Different with existing separation technology, our team used the early-found cocrystal separation method to design a step-by-step extraction and separation experiment of GEN-PUE-DDZ ternary mixture. Caffeine and L-proline were added to the mixed system in turn, GEN-caffeine cocrystal and PUE-proline cocrystal were prepared by suspension method. The cocrystals precipitated out of the solution. The purities of the GEN-caffeine cocrystal and the PUE-proline cocrystal could achieve 93% (the purity of GEN) and 99% (the purity of PUE). Besides, the purity of DDZ could also be increased by 6.76 times. This study proposed a simple operating, low cost and wide application range separation method different from the traditional separation method and realized the separation of structurally similar chemical components in TCM, laying a foundation for the application of cocrystal technology in the separation and refining of TCM.

Adolescent ; Adult ; Aged ; Blood Coagulation ; Factor XII ; genetics ; Factor XII Deficiency ; blood ; genetics ; Female ; Humans ; Male ; Point Mutation

OBJECTIVETo study endoglin (CD105) gene expression in breast cancer and its clinicopathologic significance.

METHODSIn 40 patients with breast cancers, CD105 mRNA was detected at center and periphery of tumor and at nearby normal tissue by RT-PCR.

RESULTSThe difference in CD105 mRNA expressions between cancer and normal breast tissue was significant (t = 12.08, P < 0.05), and the expression was significantly higher at the tumor periphery than at the tumor center (t = 7.52, P < 0.05). CD105 over-expression was related to lymph node metastases (t = 2.71, P < 0.05), but not to age, tumor size, pathologic grade or pathologic type (P > 0.05).

CONCLUSIONCD105 over-expression may play a crucial role in the progression of breast cancer and lymph node metastasis.

Adult ; Aged ; Antigens, CD ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; secondary ; Endoglin ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Cell Surface ; Vascular Cell Adhesion Molecule-1 ; biosynthesis ; genetics

We propose a novel strategy for multi-atlas-based image segmentation of the prostate on magnetic resonance (MR) images using an ellipsoidal shape prior constraint algorithm. An ellipsoidal shape prior constraint was incorporated into the process of multi-atlas based segmentation to restrict the regions of interest on the prostate images and avoid the interference by the surrounding tissues and organs in atlas selection. In the subsequent process of atlas fusion, the ellipsoidal shape prior constraint calibrated and compensated for the shape prior obtained by the registration technique to avoid incorrect segmentation caused by registration errors. Evaluation of this proposed method on prostate images from 50 subjects showed that this algorithm was effective and yielded a mean Dice similarity coefficients of 0.8812, suggesting its high accuracy and robustness to segment the prostate on MR images.

Objective:To explore the relationship between somatic symptoms of major depressive disorder(MDD)and cortisol(COR) rhythm, C-reactive protein(CRP) and other immune-metabolism-related indicators, and understand its mechanism from the perspective of endocrine and immune regulation.Methods:A case-control study was conducted in hospitalized patients with MDD who met DSM-5 diagnostic criteria.According to the Patient Health Questionnaire (PHQ-15), PHQ-15 ≥10 were classified as the somatic major depressive disorder group(S-MDD group) and 73 patients were enrolled.PHQ-15 <5 was classified as the non-somatic depressive disorder group (NS-MDD group) and 70 patients were enrolled.Plasma cortisol (COR8, COR16 and COR24) levels were measured at 8∶00, 16∶00 and 24∶00 on the same day, plasma CRP and interleukin-6 (IL-6) level, serum uric acid (UA), blood glucose (GLU), blood lipid (TC, TG, HDL, LDL) level were detected at 8∶00.Independent sample t test, non-parametric test, chi-square test, repeated ANOVA, covariance analysis, and multivariate Logistic regression were used for statistical analysis. Results:①Time effect, grouping effect and the interaction effect of the time and grouping in the level of COR were statistically significant ( P<0.05). Covariance analysis excluded age as an influential factor, COR16, AUC(total cortisol output/area under the curve, AUC) and COR8-16 in S-MDD group ((90.50±40.57)μg/L, (1 425.12±564.78), (-6.43±5.76))were higher than those in NS-MDD group((68.74±31.51)μg/L, (1 251.57±456.61), (-8.77±5.48)), and the difference was statistically significant ( F=8.971, 4.320, 8.731, P<0.05). ②CRP in S-MDD group ((1.41±1.06)mg/L) were higher than that in NS-MDD group((0.61±0.53)mg/L), and the difference was statistically significant ( F=25.436, P<0.05). The proportion of patients with higher CRP level(CRP≥1 mg/L) in S-MDD group(58%) was higher than that in NS-MDD group(23%), and the difference was statistically significant(χ 2=17.824, P<0.01). ③Multivariate logistic regression analysis found that CRP ( OR=4.953, 95% CI: 2.407-10.193), COR8-16 ( OR=3.451, 95% CI: 1.380-8.633) were main risk factors of somatic symptoms of MDD ( P<0.05). Conclusion:Cortisol rhythm disturbance and high CRP level may be the biological basis of somatic symptoms in patients with MDD.

OBJECTIVETo explore the diagnostic value of whole-organ magnetic resonance imaging score (WORMS) in knee osteoarthritis (KOA).

METHODSFrom November 2009 to January 2011,70 patients with KOA combined with knee effusion among outpatient and inpatient were analyzed retrospectively. Among the patients, 12 patients were male, 58 patients were female,ranging in age from 46 to 75 years,with a mean age of (59.66 +/- 9.93) years. The clinical symptoms were evaluated by WOMAC, the imaging of KOA was assessed by K-L score and WORMS, and COMP and CTX- II were measured respectively by ELISA. The correlation analyses and multiple linear regression analysis were studied to determine associations among biomarkers, clinical variables and radiographic findings of knee joints.

RESULTSThe average scores of WOMAC and WORMS were (57.50 +/- 8.20) and (64.54 +/- 16.45) respectively. The median of CTX- II nd COMP were 2.42 ng/ml and 4.56 ng/ml respectively. Grouped by less than the lowest quartile and more than the highest quartile of WORMS, COMP was significantly different (Z=2.04, P=0.039), but there was no significant difference in CTX-II (Z=0.79, P=0.427). WORMS were positively correlated with WOMAC and K-L score (r=0.777, P<0.01; r=0.716, P<0.01; respectively); WOMAC was also positively correlated with K-L score (r=0.692, P<0.01). WORMS's cartilage, osteophytes and synovitis were positively correlated with WOMAC, K-L score and COMP respectively (r=0.771, P<0.01; r=0.509, P<0.01; r=0.917, P<0.01). It was determined by stepwise regression that the KOA was mainly affected by WORMS, K-L score (P=0.015, P=0.025 respectively) when WOMAC as a dependent variable, age, gender, K-L score, WORMS, COMP and CTX- II as independent variables (F=20.327, P<0.01).

CONCLUSIONWORMS has a better reference value for diagnosis of KOA. The expression of COMP is high in the synovial fluid when WORMS at the high point. The clinical symptoms of knee osteoarthritis are mainly affected by WORMS and K-L score.

Aged ; Cartilage Oligomeric Matrix Protein ; Collagen Type I ; analysis ; Extracellular Matrix Proteins ; analysis ; Female ; Glycoproteins ; analysis ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Matrilin Proteins ; Middle Aged ; Osteoarthritis, Knee ; diagnosis ; metabolism ; physiopathology ; Peptides ; analysis

OBJECTIVETo explore in-vivo targeted imaging techniques for liver cancer detection using quantum dots (QDs) labeled probes in a nude mouse model of human hepatocellular carcinoma.

METHODSMercaptoacetic acid (MAA) modified QDs were linked to mouse-anti-human alpha-fetoprotein (AFP) monoclonal antibody to form water soluble QD-AFP-Ab probes, which were validated by spectra analyses and transmission electron microscope. The probes were firstly used to detect AFP antigen in human hepatocellular carcinoma cell line HCCLM6 in-vitro by one-step immunofluorescence method. In-vivo tumor xenografts and lung metastases models were then established by inoculation of HCCLM6 cells subcutaneously and into the tail vein of nude mice, respectively. QD-AFP-Ab probes were injected into the tail vein of the tumor bearing mice for live animal fluorescence imaging. Spectra of tumor and normal tissue were analyzed under illumination of Ti: sapphire laser. Serum levels of alanine amino transferase, aspartate amino transferase, blood urea nitrogen and creatinine were determined by conventional biochemical analysis. The liver, spleen, lungs, kidneys, heart and brain of the experimental nude mice were investigated for nonspecific uptake of the probes by confocal microscope.

RESULTSThe QD-AFP-Ab probes had broad excitation spectra and high fluorescence intensity. They could specifically and efficiently recognize AFP antigen in hepatocellular carcinoma cells. Tumor targeting imaging using these probes were successful without any acute toxicity to the experimental animals. Spectra analysis showed that the probes per field were lower in the centre than the periphery of the tumor. Non-specific uptake of QD-AFP-Ab probes occurred mainly in the liver, spleen and lungs.

CONCLUSIONSQD-AFP-Ab probes have good optical properties and biocompatibility for in-vivo targeted imaging of hepatocellular carcinoma. Such approach promises to be highly desirable for molecular targeted research of liver cancer.

Animals ; Antibodies, Monoclonal ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Diagnostic Imaging ; methods ; Fluorescent Antibody Technique ; methods ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Lung Neoplasms ; metabolism ; secondary ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microscopy, Fluorescence ; Molecular Probes ; metabolism ; pharmacokinetics ; toxicity ; Neoplasm Transplantation ; Quantum Dots ; Tissue Distribution ; alpha-Fetoproteins ; immunology ; metabolism

OBJECTIVETo observe the change of apelin and its receptor (APJ) in the lung tissue of rats with pulmonary hypertension induced by monocrotaline and to explore its significance.

METHODSTwenty-five male SD rats were randomly divided into control group (n = 10) and monocrotaline group (n = 15). On the twenty-first day after the rats were intraperitoneally injected 60 mg/kg monocrotaline for monocrotaline group or equal volume vehicle for control group, the mean pulmonary artery pressure was measured by right heart catheterization. Histopathological study of lung tissue was done with hematoxylin-eosin (HE) and Masson's trichrome staining. The concentration of apelin in the plasma was measured by radioimmunoassay. The expressions of apelin/APJ proteins and genes in lung tissue were measured respectively by Western blot and reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThe mean pulmonary arterial pressure, right ventricular hypertrophy, pulmonary vascular remodeling index, content of apelin protein in lung tissue of monocrotaline group were higher than those in control group. APJ protein and gene expression in monocrotaline group were significantly lower than those in control group (P < 0.01, P < 0.05), but apelin gene expression in the lung tissue between the two groups had no significant difference.

CONCLUSIONEndogenous apelin/APJ dysfunction may play an important role in the development of pulmonary hypertension induced by monocrotaline.

Animals ; Apelin ; Apelin Receptors ; Hypertension, Pulmonary ; chemically induced ; metabolism ; Intercellular Signaling Peptides and Proteins ; metabolism ; Lung ; metabolism ; Male ; Monocrotaline ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; metabolism