Objective To analyze the mutation distribution of phenylalanine hydroxylase(PAH)gene in pa-tients with phenylketonuria(PKU)in Ningxia,and understand the hot spots and regions of PAH gene. Methods First-ly,6 hot mutation exons including 3,5,6,7,11,12 and their surrounding introns of the PAH gene in 30 patients with PKU in Ningxia were directly sequenced. And then the last 7 exons of 1,2,4,8,9,10,13 were sequenced for the patients in which 2 mutant alleles were not characterized. Multiplex ligation - dependent probe amplification (MLPA)was performed for the identification of uncharacterized mutant alleles after PAH sequence analysis of patients with PKU. Results Among 60 alleles,there were 58 mutant alleles(96. 7% ). Forty - six(81. 6% )mutant alleles were found in the exons 3,5,6,7,11,12. A total of 23 various mutations were detected,including missense(n = 9), splicing(n = 9),nonsense(n = 2),small deletion(n = 2)and large deletion(n = 1). The most common mutations were R243Q(18. 3% ),IVS4 - 1G ﹥ A(11. 7% )and R111X(11. 7% ). Among them,a novel mutation N393del was detec-ted in exon 11. MLPA identified a large deletion(c. - 1932 + 3402del)in 3 patients,1 of them was homoallelic muta-tion,and the others were heteroallelic mutation. Conclusions There are obvious hotspots and hot spot areas of PAH gene in PKU patients in Ningxia. There is a large deletion mutation in PKU patients in Ningxia. The MLPA is an effec-tive assay to detect large deletion in PAH gene.

Objective To evaluate the PDCA cycle on the rehabilitation of postoperative patients with anal fistula, aiming at improving the recovery of patients and preventing recurrence. Methods 144 postoperative patients of anal fistula were randomly divided into the observation group and the control group with 72 cases in each group. The observation group received intervention based upon the PDCA cy-cle, and the control group was given the traditional oral propaganda. The recovery time, recurrence rate, mastering of education content and self-control ability were compared in the two groups using t test and χ2 test. Results The mastering level of education content and the self-management skills in the observation group were superior to those of the control group. After 3 to 24 months of follow-up, the observation group showed shorter recovery time and less recurrence rate than that of the control group. Conclusions Nurs-ing intervention based upon PDCA cycle can strengthen the patients' mastering of related knowledge, pro-mote the recovery, reduce recurrence rate and improve the patients' quality of life.

Objective To evaluate the clinical efficacy of the local drug resistance spectrum antibiotics and foreign guideline in the treatment of patients with community acquired pneumonia(CAP). Methods A prospective,randomized,single blind,and positive drug parallel controlled design was used in the treatment. CAP patients with no underlying disease outpatients and inpatients<48 hours were selected as the research object. The patients in the trial group were given sensitive local drug resistance spectrum antibiotics: moxifloxacin,400 mg and 1 times a day. The patients in the control group were given azithromycin tablets(each 500 mg,once daily) promulgated by the 2007 version of the IDSA / ATS adult CAP guideline. Results There were 106 cases of CAP patients,of which 77 cases completed treatment,including 39 cases in the experimental group and 38 cases in the control group. There were significant differences in the clinical efficacy and bacterial clearance rate between the two groups,with the clinical efficacy of 89.7% and 68.4%(P < 0.01),the bacterial clearance rate of 87.9% and 54.5%(P < 0.05),respectively. Conclusion The clinical efficacy of drug resistant spectrum sensitive antibiotics in the treatment of CAP in Kunming was better than that of IDSA/ATS. Clinicians should pay attention to the characteristics and composition of resistance of common pathogenic bacteria in our country during the study and reference from foreign guideline,and adjust the therapeutic regimen according to the changes of the local drug resistance monitoring data rather than copy the recommended treatment plan by foreign countries.

BACKGROUNDEpidemiological studies have shown that both active and passive cigarette smoking increase the risk of atherosclerosis. But very little is known about the biological processes induced by passive cigarette smoking that contribute to atherosclerosis. We observe the expression of a few of biological and inflammatory markers in human arterial walls in vitro which were treated with the second-hand smoke solution (sidestream whole, SSW), and discuss the possible mechanism of inflammatory injury induced by second-hand smoke.

METHODSThe biological markers (platelet endothelial cell adhesion molecule-1, PECAM-1; alpha-smooth muscle actin, alpha-SMA; collagen IV, Col IV) and inflammatory markers (vascular cell adhesion molecule-1, VCAM-1; monocyte chemoattractant protein-1, MCP-1; interleukin-8, IL-8) of human aortal wall were tested by immunofluorescence staining. The levels of MCP-1 and IL-8 mRNA expression were detected by reverse transcription-polymerase chain reaction (RT-PCR).

RESULTSNo distinct difference was observed between SSW and the control group on the expression of biological markers as assessed by the light microscope. But the inflammatory markers VCAM-1, MCP-1 and IL-8 on the subendothelial layer and smooth muscle cell layers, which are near the endothelium of arterial wall, were strongly stained in the SSW group compared with the control group. Their fluorescence intensities in the 1:40 SSW group (VCAM-1: 0.35 +/- 0.04, MCP-1: 0.34 +/- 0.05, IL-8: 0.37 +/- 0.05) and the 1:20 SSW group (VCAM-1: 0.40 +/- 0.04, MCP-1: 0.52 +/- 0.09, IL-8: 0.51 +/- 0.07) were significantly stronger than the control group (VCAM-1: 0.12 +/- 0.04, MCP-1: 0.06 +/- 0.02, IL-8: 0.24 +/- 0.03) by semi-quantitative analysis of immunofluorescence (P < 0.001 vs control). MCP-1 mRNA expression in the 1:40 SSW (0.15 +/- 0.04) and the 1:20 SSW (0.19 +/- 0.06) group was significantly higher than in the control group (0.09 +/- 0.03) (P < 0.05, P < 0.01 vs control); IL-8 mRNA expression in the 1:40 SSW (0.64 +/- 0.12) and 1:20 SSW (0.72 +/- 0.13) groups was also significantly higher than that in the control group (0.49 +/- 0.13) (P < 0.05, P < 0.01 vs control) by RT-PCR.

CONCLUSIONSIt is implied that a second-hand smoke solution induces the inflammatory reaction of the arterial wall by release of inflammatory factors even though there is no distinct structural change on the arterial walls under light microscope, indicating that passive cigarette smoking is related to inflammatory injury in human arterial wall and could be closely related to the early inflammatory stage of atherosclerosis.

Adult ; Arteries ; cytology ; drug effects ; metabolism ; Cells, Cultured ; Fluorescent Antibody Technique ; Humans ; In Vitro Techniques ; Inflammation ; chemically induced ; Male ; Reverse Transcriptase Polymerase Chain Reaction ; Tobacco Smoke Pollution ; adverse effects

OBJECTIVETo elevate the immunological effect of subunit influenza vaccine in infants and aged people (over 60) using liposomal adjuvant in the context of its relatively low immunity and to investigate the relation between vaccine antigens and liposomal characteristics.

METHODSSeveral formulations of liposomal subunit influenza vaccine were prepared. Their relevant characteristics were investigated to optimize the preparation method. Antisera obtained from immunizinged mice were used to evaluate the antibody titers of various samples by HI and ELISA.

RESULTSLiposomal trivalent influenza vaccine prepared by film evaporation in combinedation with freeze-drying significantly increased its immunological effect in SPF Balb/c mice. Liposomal vaccine stimulated the antibody titer of H3N2, H1N1, and B much stronger than conventional influenza vaccine. As a result, liposomal vaccine (mean size: 4.5-5.5 microm, entrapment efficiency: 30%-40%) significantly increased the immunological effect of subunit influenza vaccine.

CONCLUSIONThe immune effect of liposomal vaccine depends on different antigens, and enhanced immunity is not positively correlated with the mean size of liposome or its entrapped efficiency.

Animals ; Influenza A Virus, H1N1 Subtype ; immunology ; Influenza A Virus, H3N2 Subtype ; immunology ; Influenza B virus ; immunology ; Influenza Vaccines ; administration & dosage ; immunology ; Liposomes ; Mice ; Mice, Inbred BALB C ; Orthomyxoviridae Infections ; prevention & control ; Specific Pathogen-Free Organisms ; Vaccines, Subunit ; administration & dosage ; immunology

OBJECTIVETo study the distribution of genomovars and microevolution of Yersinia pestis in the Qinghai-Tibet Plateau.

METHODSPrimer pairs targeting the twenty-two different regions(DFRs) were designed for detecting the presence or deletion of each DFR in 297 strains isolated from the Qinghai-Tibet Plateau.

RESULTS9 genomovars, i. e. Genomovar 1, 5, 6, 7, 8, 10, 11, new type and Ype-ancestor were identified in the Marmota himalayana plague focus of the Qinghai-Tibet Plateau. Among these genomovars, genomovar 5,8 and 10 were dominant types. The total rate of the three genomovars was 80.6% (204/253) and the genomovars in different regions were different. All of 44 strains of Y. pestis in the Microtus fuscus plague focus of the Qinghai-Tibet Plateau belonged to genomovar 14.

CONCLUSIONThe distribution of genomovars of Y. pestis in the Qinghai-Tibet plateau had remarkable characteristics geographically. Based on the distribution of genomovars of Y. pestis, the routes of transmission and microevolution of Y. pestis were proposed.

Biological Evolution ; China ; Geography ; Humans ; Plague ; transmission ; Yersinia pestis ; genetics

OBJECTIVETo evaluate the clinical efficacy of acupuncture for treatment of diarrhea-predominant irritable bowel syndrome and discuss its action mechanism.

METHODSFifty-seven cases were randomly divided into two groups. The acupuncture group (29 cases) was treated with acupuncture at Taichong (LR 3), Zusanli (ST 36) and Sanyinjiao (SP 6) etc., once a day and 5 times per week. The medication group (28 cases) was treated with oral administration of pinaverium (50 mg each time, 3 times a day) and live combined bifidobacterium and lactobacillus tablet (4 tablets each time, 3 times a day). Four weeks were taken as a treatment course in both groups. Before and after treatment ELISA method was applied to measure the level of serum 5-HT of the patients in two groups. The scores of clinical symptoms were observed before treatment, after one and four weeks of treatment and 3 months after treatment, respectively.

RESULTSThe level of serum 5-HT was significantly reduced in the acupuncture group and medication group (P < 0.01, P < 0.05), which had no statistical difference between two groups (P > 0.05). Compared with the medication group, the scores of clinical symptoms were obviously improved in the acupuncture group after one and four weeks of treatment and 3 months after treatment (P < 0.01, P < 0.05). The total effective rate was 89.66% (26/29) in the acupuncture group, which was superior to 67.85% (19/28) in the medication group (P < 0.05).

CONCLUSIONThe efficacy of acupuncture is superior to that of medicine in the treatment of diarrhea-predominant irritable bowel syndrome. The acupuncture treatment could reduce the visceral sensitivity, improve the intestinal motility and regulate the imbalance of brain-intestine interactive function.

Acupuncture Points ; Acupuncture Therapy ; Diarrhea ; blood ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; blood ; therapy ; Male ; Serotonin ; blood ; Treatment Outcome

OBJECTIVETo study the value of high-frequency ultrasound in the diagnosis of duchenne muscular dystrophy diseases (DMD) in children.

METHODSEight children with DMD were enrolled as DMD group and 10 healthy children as the control group. The echogenicity of the rectus femoris muscle and the gap between the gastrocnemius and soleus muscles in the two groups were detected by high-frequency ultrasound.

RESULTSCompared with the control group, rectus femoris and gastrocnemius muscles in the DMD group showed increased echogenicity and their muscle fibers were arranged irregularly, and the gap between the gastrocnemius and soleus muscles became wilder (P<0.01).

CONCLUSIONSHigh-frequency ultrasound is valuable in the diagnosis of DMD.

Child ; Child, Preschool ; Female ; Humans ; Male ; Muscular Dystrophy, Duchenne ; diagnostic imaging ; Ultrasonography

OBJECTIVETo evaluate the relationship of expressions of nucleoside diphosphate kinase (nm23) and proliferating cell nuclear antigen (PCNA), as well as apoptosis, with the prognosis of HCC patients by analyzing their pathological and clinical data.

METHODSThe expressions of nm23 and PCNA were analyzed by immunohistochemistry and the apoptotic phenomena were detected by TUNEL technique in the liver samples from 43 HCC tissues, 39 para-neoplastic tissues, and 10 normal tissues. The mean apoptosis index (AI) and proliferative index (PI) in individual sample were calculated.

RESULTSAs shown by the detection, 32.6% of carcinomas had negative nm23 signal in tumor tissues, whereas all para-neoplastic and normal tissues had positive nm23. The AI in nm23 positive HCC was significantly higher than that in nm23 negative one, with statistical difference (P<0.05). Furthermore, the expressions of nm23, and the values of AI and PI were contrastively analyzed with some main pathological and clinical data of HCC. It revealed that HCC with extrahepatic metastasis showed remarkable correlation with the negative nm23 (P=0.013) and higher PI values of HCC (P=0.015). The disease-free survival in HCC patients with negative nm23 expression was significantly poorer than that in patients with positive nm23 expression.

CONCLUSIONSThese data suggest that expressions of nm23 protein in tumor tissues are correlated with occurrences of metastasis and length of survival of the HCC patients, which may be an indicator for their prognosis.

Adult ; Aged ; Apoptosis ; Biomarkers, Tumor ; biosynthesis ; Carcinoma, Hepatocellular ; enzymology ; mortality ; pathology ; Case-Control Studies ; Cell Proliferation ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Kaplan-Meier Estimate ; Liver ; enzymology ; pathology ; Liver Neoplasms ; enzymology ; mortality ; pathology ; Male ; Middle Aged ; NM23 Nucleoside Diphosphate Kinases ; biosynthesis ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen ; biosynthesis

BACKGROUNDWe investigated whether and to what extent the ratio between circulating fibrinogen (Fg) and its degradation products (FDP) reflects the severity of coronary artery disease (CAD) in type 2 diabetic patients.

METHODSPlasma levels of Fg and FDP were determined, and Fg/FDP ratio was calculated in 344 consecutive patients with type 2 diabetes and chest pain on exertion undergoing coronary angiography. The severity of CAD was evaluated by the number of significant CAD (>50% luminal diameter narrowing) and Gensini score.

RESULTSPlasma Fg was higher, but Fg/FDP ratio was lower in patients with significant CAD (n = 255) compared with those without (n = 89), due to a disproportionate increase in FDP. Fg and FDP correlated positively, while Fg/FDP ratio negatively, with the number of diseased coronary arteries and the tertile of Gensini score (all P values for trend < 0.01). After adjusting for age, sex, risk factors for CAD, lipid profiles, glycosylated hemoglobin A1c, creatinine, leukocyte count, and high-sensitivity C-reactive protein, Fg/FDP ratio remained an independent determinant for multivessel coronary disease (MVD) (odds ratio [OR], 0.869; 95% confidence interval [CI], 0.788-0.958, P = 0.005) and high tertile of Gensini score (OR, 0.797, 95% CI, 0.682-0.930, P = 0.004). The area under the curve of Fg/FDP ratio was larger than that of Fg for predicting the presence of MVD (0.647 vs. 0.563, P = 0.048) and Gensini score ≥ 30 (0.656 vs. 0.538, P = 0.026).

CONCLUSIONSElevated plasma Fg and FDP level and reduced Fg/FDP ratio are associated with presence of CAD, and Fg/FDP ratio is superior to Fg in reflecting severe coronary atherosclerosis for patients with type 2 diabetes.

Aged ; Coronary Angiography ; Coronary Artery Disease ; blood ; diagnosis ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; Female ; Fibrin ; metabolism ; Fibrinogen ; metabolism ; Humans ; Male ; Middle Aged