Objective To explore the relationship between subclinical hypercortisolism (SH) and osteoprosis.Methods MEDLINE,BIOSIS Previews,High Wire Wanfang Database,and Vip Database were retrieved for articles about the relations of SH and osteoporosis.Searches were limited to Chinese/English-language publications.The clinical outcomes evaluated in this study included bone mineral density,biochemical markers of bone turnover,prevalence of osteoporosis,and incidence of fracture.Meta-analysis was carried out by RevMan5 among articles suitable for the inclusion and exclusion criteria.Results Fifteen studies were included,containing 6retrospective studies,6 prospective studies,and 3 intervention studies.Retrospective studies suggested that bone mineral density level in subclinical hypercortisolism group (SH + group) was significantly lower than that in the nonsubclinical hypercortisolism group (SH-group),meta-analysis of prospective studies showed that the level of bone mineral density at lumbar spine and femoral neck was significantly lower in SH+ group than that in the SH-group(all P＜0.01).Both retrospective studies and prospective studies showed no significant difference between the biochemical markers of bone turnover in both SH+ and SH-groups.Data from intervention studies showed that the prognosis in SH patients with surgical intervention was not improved.Conclusions SH reduces bone mineral density at lumbar spine and femoral neck,and increases the prevalence of osteoporosis and incidence of fracture.Whether surgical intervention is beneficial in SH patients remains uncertain.

Objective To investigate the efficacy and safety of percutaneous microwave ablation in the treatment of hypersplenism.Methods From March 2007 to May 2011,38 patients with hepatitis B virus caused liver cirrhosis and complicated with hypersplenism received percutaneous microwave ablation treatment for several times.Before percutaneous microwave ablation treatment,the volume of spleen was calculated according to 3D computed tomography (CT) scan.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were also tested.For the first time,1/3 volume of spleen was ablated.If no complication were observed in one week after ablation,then another 1/3 volume of spleen was ablated.Blood routine and liver function test were checked on the 1st,3rd and 5th day after microwave ablation.Blood routine,liver function test and ultrasound were examined on 7th and 14th day after microwave ablation.On the 30th day CT examination was conducted.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were detected at one month,three month and every three month after microwave ablation.The follow up duration was over two years.The t-test was performed for clinical data comparison.Results The mean ratio of ablated spleen was (47 ±5)％ (range 41％ to 57％).Preoperative white blood cell count was (2.46±0.78)× 109/L,which gradually increased after operation and peaked on the 3rd day after operation ((5.34 ± 2.10) × 109/L).Then gradually decreased,which was (3.16 ± 1.02) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t=-3.349,P＜0.01).Preoperative platelet count was (46.58 ± 17.30) × 109/L,which gradually decreased after operation and was lowest on the 3rd day after operation.Then gradually increased,which peaked at 30 days after operation ((101.79 ± 25.80) × 109/L) and then gradually decreased,which was (61.97 ± 15.09) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t＝-4.135,P＜0.01).The inner diameter of portal vein was (14.66±0.88) mm preoperation,which was (13.22±0.64) mm at three month after operation and the difference was statistically significant compared with that of preoperation (t=8.145,P＜0.01).It was (14.64±0.81) mm at six month after operation and the difference was not statistically significant compared with that of preoperation (P＞ 0.05).The major adverse effects were fever,left upper abdominal pain,left shoulder pain,pleural effusion,intraperitoneal hemorrhage and temporary hemoglobinuria which all recovered after symptomatic treatment.No severe complication such as uncontrollable bleeding,splenic abscess,spleen rupture and the surrounding organ injury and treatment related death were observed.Conclusion Percutaneous microwave ablation for several times could safely destroy suitable volume of spleen,increase platelet and white blood cell count,improve portal hypertension and with rare complications,which might be a minimally invasive techniques with clinical application value in the treatment of the hypersplenism.

BACKGROUND:Neural stem cels can repair the damaged brain tissues with potentials of proliferation and differentiation, which become one of the important directions for treating cerebral palsy. OBJECTIVE:To observe the clinical effect and safety of neural stem cel transplantation on the treatment of cerebral palsy in children. METHODS:Neural stem cels were isolated from human embryonic brain and identified by immunofluorescence staining, which were transplanted intravenously into 26 children with cerebral palsy. Children's motor functions were evaluated by gross motor function measure scale and Peabody development motor scale-fine motor scale before treatment, and 3 and 6 months after treatment. Routine blood test and liver-kidney function were detected before and after treatment. Clinical adverse reactions in children with cerebral palsy were monitored. RESULTS AND CONCLUSION:The lost cases were not found during 6 months of folow-up. Specific proteins of neural stem cels were al positive in this study. At 3 and 6 months after transplantation, the A, B, C functional area scores and total score on the gross motor function measure scale were obviously increased (P < 0.05,P < 0.01), but the C and D functional area scores were not remarkably elevated (P > 0.05). At 3 months after transplantation, the fine motor quotient, grasping subtest and visual-motor integration were not remarkably increased (P > 0.05); these scores, however, were elevated after 6 months with statistical significance (P < 0.05, P < 0.01). The results of routine blood test and liver-kidney function in 26 children were in normal range, and there were no serious adverse reactions during the cel transplantation. Therefore, neural stem cel transplantation has high safety and good curative effects to improve the motor function of children with severe cerebral palsy, especialy for gross motors.

Objective To investigate the characteristics and the correlative factors of constipation in Parkinson's disease (PD) patients.Methods The demographic information,clinical features and history of medications of 193 patients with idiopathic PD consulting in the outpatient department of the First Affiliated Hospital,Anhui Medical University were collected.Patients were evaluated using following scales:Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ),Hoehn-Yahr stage,Bristol Scoring Scale,Cleveland Constipation Scoring Scale (CCS),Scale for Outcomes in PD-autonomic for Autonomic Symptoms,Simple Food Frequency Questionnaire,Hamilton Depression Scale (HAMD),Mini Mental State Examination.The patients were divided into constipation group and non-constipation group based on Rome Ⅲ Criteria for Diagnosis of Functional Constipation,and the correlative factors of constipation were compared and analyzed between the two groups.The severity of constipation and influencing factors were also compared between patients with early onset constipation (occurred before present of motor symptoms) and patients with late onset constipation (occurred after present of motor symptoms).The impacts of anti-PD medication adjustments on constipation were assessed by observing the alteration of constipation severity in 41 PD patients.Results The incidence of constipation was 56.4％ (109/193) in our cohort of PD patients,and 21.1％ (23/109) of constipation was severe according to the assessing by CCS.The spectrum of constipation symptoms included defecation straining (89.9％,98/109),poor stool output (67.9％,74/ 109),reduced stool frequency (63.3％,69/109) and dryness of stool (60.5％,66/109).The age,disease duration,scores of Hoehn-Yahr stage,UPDRS Ⅲ and HAMD,levodopa equivalent dose (LED),frequency of urination disturbance in constipation group were significantly higher than those in nonconstipation group,while the daily quantities of vegetable and water intake in constipation group were significantly lower than those in non-constipation group.Age and HAMD scores were the independent risk factors of constipation (OR=1.049,95％ CI 1.014-1.086,P=0.006;OR=1.316,95％ CI 1.185-1.461,P =0.000).Among the 109 constipation patients,the course of PD,scores of Hoehn-Yahr stage,UPDRSⅢ and LED were positively correlated with the severity of constipation (r =0.269,0.338,0.315,0.341,0.371,all P ＜ 0.05),with HAMD score being the independent risk factor of constipation severity (OR =1.175,95％ CI 1.044-1.322,P ＜ 0.05).The severity of constipation and risk factors of constipation in patients with early onset constipation were not distinct from those with late onset constipation.Conclusions The incidence of constipation increases with the increment of age,disease duration,Hoehn-Yahr stage,UPDRS Ⅲ scores,LED,HAMD scores,urination disorder severity and the decrement of daily water and vegetable intakes.The severity of constipation is positively related to the severity of motor symptoms,the daily dose of anti-PD drugs and depression levels.PD patients with early onset constipation are not distinct from the patients with late onset constipation in terms of severity and risk factors.The influences of anti-PD drugs on constipation are variable depending on the specific drug used and individual constitution.Individualized treatment regimes are proposed with respect to the management of constipation according to the specific risk factors in PD patients.

In order to investigate the levels of stem cell factor (SCF) and its receptor c-kit protein and mRNA in pediatric aplastic anemia (AA) and their relevance to the pathogenesis, immunocytochemical and in situ hybridization were utilized to detect the expression of SCF and its receptor c-kit gene protein and mRNA, respectively in 59 children with AA and 51 normal controls. The relationship between SCF and c-kit and the pathogenesis of AA was analyzed subsequently. The results showed that the positive rate of SCF protein and mRNA expression in children with AA was significantly lower than that in healthy controls (P < 0.05). However, there was no significant difference in the positive rate of c-kit protein and mRNA expression between children with AA and control group (P > 0.05). It was concluded that the expression of SCF is significantly decreased in children with AA, which may be closely associated with the pathogenesis of the AA. c-kit may be unrelated to the development of pediatric AA. Therefore, AA in children may have abnormalities at SCF/c-kit signal transduction levels.
Anemia, Aplastic/etiology ; Anemia, Aplastic/*metabolism ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Receptors, Colony-Stimulating Factor/*biosynthesis ; Receptors, Colony-Stimulating Factor/genetics ; Stem Cell Factor/*biosynthesis ; Stem Cell Factor/genetics

OBJECTIVETo prepare CIT microemulsion and to investigate its properities and the absorption character in rat intestine in situ.

METHODThe optimum formulation of the blank microemulsion was selected by pseudo tertiary phase diagrams and the CIT microemulsion was prepared based on the blank microemulsion. The appearance, particle diameter distribution and Zeta potential were investigated by electron microscopy and grainsize analyzer. The entrapment efficiency was determined by sephadex column chromatography. An in situ single pass intestine perfusion method was used to investigate the intestinal absorption of CIT microemulsion. HPLC method for determination of CIT in the intestinal flux was established.

RESULTThe formulation was OP-glycerol-water-ethylis oleas (3:3:4:2). CIT microemulsion in electron microscopy was consisted of small spherical drop. The mean diameter was 61.7 nm, Zeta potential was -46.3 mV. The Entrapment efficiency was (92.1 +/- 1.74)% (n=3). Both CIT and CIT microemulsion had been absorbed in general intestinal tract,and the absorption of CIT microemulsion was significantly high compared with CIT in duodenum, colon, jejunum and ileum (P < 0.01).

CONCLUSIONThe preparation technology of CIT microemulsion was feasible,and the microemulsion system might improve the absorption of CIT in the intestinal tract.

Animals ; Drug Compounding ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Emulsions ; chemistry ; Intestinal Absorption ; Models, Animal ; Particle Size ; Rats ; Rats, Sprague-Dawley

In order to investigate the levels of stem cell factor (SCF) and its receptor c-kit protein and mRNA in pediatric aplastic anemia (AA) and their relevance to the pathogenesis, immunocytochemical and in situ hybridization were utilized to detect the expression of SCF and its receptor c-kit gene protein and mRNA, respectively in 59 children with AA and 51 normal controls. The relationship between SCF and c-kit and the pathogenesis of AA was analyzed subsequently. The results showed that the positive rate of SCF protein and mRNA expression in children with AA was significantly lower than that in healthy controls (P＜0.05). However, there was no significant difference in the positive rate of c-kit protein and mRNA expression between children with AA and control group (P＞0.05). It was concluded that the expression of SCF is significantly decreased in children with AA, which may be closely associated with the pathogenesis of the AA. c-kit may be unrelated to the development of pediatric AA. Therefore, AA in children may have abnormalities at SCF/ckit signal transduction levels.

Objective To study the effects of vision on human postural control and the connection mechanisms of the brain's functional network.Methods 15 healthy male adults were required to perform 30 s of balanced standing on both legs with eyes open and eyes closed.The center of pressure(COP)and electroencephalograph(EEG)were recorded during balance.The sample entropy(sample En)of the COP was calculated.The phase lag index(PLI)in θ-,α-,β-band of EEG was calculated to construct the brain functional networks,and the clustering coefficient(C),characteristic path length(L),and the criteria(σ)of the small-world network were calculated based on graph theory.Results During balanced standing on both legs,the SampleEn of the COPY with eyes closed was significantly higher than that with eyes open(P＜0.05).The mean value of PLI in the α-band under the eyes closed state was significantly higher than that under the eyes open state(P＜0.05).The C and σ values in the α-band under the eyes closed state were significantly higher than those under the eyes open state,and the L value was significantly lower than that under the eyes open state(P＜0.05).The frontal-central-parietal connectivity and the central-parietal connectivity strength in the α-band under the eyes closed state were significantly higher than those under the eyes open state(P＜0.05).The average PLI and C values in the α-band were moderately negatively correlated with the SampleEn of COPY (P＜0.05).The average PLI of the left prefrontal area,left parietal area,and left occipital area in the α-band under the eyes closed state had a moderate negative correlation with the SampleEn of COPY.The average PLI of the left central region and the right occipital area in the eyes-closed state was moderately negatively correlated with the SampleEn of COPY.Conclusions During the standing balance,when there is no visual input,the stability of body balance decreases,accompanied by enhanced brain network connectivity in α-band and the requirement for efficiency enhancement in information processing in the brain.The brain adopts different neural strategies when performing postural control under various visual conditions.

Objective:To retrieve, evaluate, and integrate the best evidence of low-fiber diet bowel preparation before colonoscopy in children, providing a basis for clinical nursing practice.Methods:Guidelines, systematic reviews, evidence summaries, expert consensus, randomized controlled trials and so on related to bowel preparation for low-fiber diet before colonoscopy in children were searched through computers in domestic and foreign databases, guideline websites and professional association websites. The search period was from database establishment to October 31, 2021. The evidence included was graded using the Joanna Briggs Institute (JBI) evidence pre-grading and evidence recommendation grading system (2014 version) in Australia.Results:A total of 8 articles were included, including four guidelines, one evidence summary, one systematic review, one expert consensus, and one randomized controlled trial. A total of 25 pieces of evidence were summarized from 7 aspects, including assessment before eating, duration of dietary restriction, dietary content, evaluation indicators, eating effectiveness, bowel preparation methods, and health education.Conclusions:This study strictly follows evidence-based methods and summarizes the best evidence of low-fiber diet bowel preparation before colonoscopy in children. This can provide reference for the standardization of low-fiber diet bowel preparation before colonoscopy in children in China, and improve the quality of bowel preparation before colonoscopy in children.

Hypoxia-inducible factor-1 (HIF-1) is a critical nuclear transcriptional factor mediating cell adaptive response to hypoxia in mammalian and human .It is the key mediator which modulates oxygen homeostasis exclusively .In the one hand , HIF-1 can protect and promote kinds of physiological processes , such as embryo normal development , cartilage and bone formation .In the other hand, it is also involved in lots of human deceases which is caused by ischemia and hypoxia , such as tumor, diabetes and its complica-tions.The molecular mechanisms of HIF-1 involved in these diseases have become a research hotspot and such studies will provide the new therapeutic means for these diseases , recent new drug researches have been focused on HIF-1 related signal pathway inhibitors , HIF-1 activity inhibitors, HIF-1 targeted therapy, etc.