Since the first reported case of swine influenza A in Mexico, a total of 15 510 cases have been confirmed in 53 countries by May 29, 2009. On April 29, 2009, the World Health Organization (WHO) raised its pandemic alert from grade 4 to grade 5. The virus is described as a new subtype of A/H1N1 and is not detected in pigs or humans previously. The virus is sensitive to oseltamivir and zanamivir, but resistant to amantadine and rimantadine. The genetics of the virus are so novel that humans are unlikely to have much immunity to it. The virus can transmit from human to human; therefore it is necessary to enforce quarantine measure for close contactors because the virus transmits during latency. Precaution methods like covering noses and mouths with a tissue when coughing or sneezing can reduce the transmission opportunity. Hands should be washed frequently with soap, especially after coughing or sneezing. Public places with ventilation conditions, personal health behavior and health condition are critical for the prevention and control of this epidemic.

Objective: To analyze evolutionary characteristics of the matrix protein (M) and nucleoprotein (NP) genes of influenza virus A/H1N1 in 2009 pandemic. Methods: The M and NP genes of A/H1N1 viruses were downloaded from NCBI database. MEGA4.0 software and NJ method were used for sequence alignment, protein sequence alignment, and the phylogenetic tree construction. Meanwhile, Epi Info software was used to analyze the linear trend of evolutionary distance of the M and NP genes of human H1N1 strains isolated during 1918 to 2009. Results: The M and NP gene sequences were similar among the novel A/H1N1 viruses, but different from those of the previous influenza H1N1 viruses. Using reference sequences of human H1N1 strains isolated during 1918 to 2008, we found that changes in evolutionary distances of the M genes between novel A/H1N1 strains and each of the reference A/H1N1 strains increased with increasing year intervals (Ptrend = 0.001). Compared with the amino acid sequence of M2 protein of reference human A/H1N1 virus strains isolated during 1918 to 2008, the novel A/H1N1 viruses had the amino acid substitutions at 6 sites: 11, 43, 54, 57, 77, and 78. Compared with swine and avian A/H1N1, the novel A/H1N1 virus only had the amino acid substitutions at 43 and 77. Conclusion: The NP gene of novel A/H1N1 virus, which is routinely considered as a conserved sequence, is different from those of the previously isolated human H1N1 influenza viruses; the related mechanisms and consequences on viral activity remain to be elucidated. The substitution to threonine at 11 and 43 amino acids of M2 protein might contribute to amantadine resistance of the novel H1N1 virus pandemic in 2009.

Objective To study diagnosis and treatment of rhabdomyosarcoma (RMS) in children.Method The clinical data of 43 children with RMS was retrospectively reviewed from Nov 2004 to May 2012.Their long-term survival was followed up.Forty-three children with RMS(male 26,female 17) in Beijing Tongren Hospital were enrolled.Their median age on diagnosis was 6 years old.We confirmed the diagnosis according to pathological diagnosis.Comprehensive treatment included chemotherapy,surgery and implantation of radioactive seeds,and so on.Statistical analysis was used on clinical data and treatment efficacy.Result The median follow up time of 43 cases with RMS in children was 31 mouths until May 2012.Four cases abandoned,39 cases were followed up.The cases of complete remission were 27(69％),and the cases of partly remission were 7 (18％),and the cases of dead were 5 due to cerebral metastasis.Overall survival rate was 87％ (34/39).Eight cases were treated with 125Ⅰ particles implants into its location,7 cases responded,1 case was invalid.Conclusion Although anatomic structure of RMS of head and neck was very complex,and the prognosis of it with metastatic disease was inferior,the muttidisciplinary treatment can still improve the clinical remission rate.In particular,high risk RMS with 125Ⅰ particles implants and large dose chemotherapy would be beneficial.

To observe the therapeutic effects of transcutaneous electric acupoint stimulation on early-stage adhesive shoulder periarthritis. Methods:by using the research approach of evidence-based medicine such as multi-center,large sample and randomization,the 163 cases of early-stage adhesive shoulder periarthritis were treated with transcutaneous electric point stimulation and electric acupuncture respectively to observe the therapeutic effect of transcutaneous electric acupoint stimulation and compare its effect with electric acupuncture.Results and Conclusion:The total effective rate of transcutaneous electric point stimulation on early-stage adhesive shoulder periarthritis reached 96.5%,showing no significant difference with the electric acupuncture group;the transcutaneous electric acupoint stimulation could not only relieve pain,but also improve the shoulder joint movement. As a result,the transcutaneous electric acupoint stimulation is an easy and more effective therapy for shoulder periarthritis.

Objective To explore the application and clinical outcome of intracapsular reduction for comminuted distal radial fractures.Methods From January 2003 to October 2005,37 cases of comminuted fractures of distal radius were treated in our hospital.They were categorized according to the AO classification,and underwent open intracapsular reduction,internal fixation with either locking com- pressing plate(LCP)or external fixator according to the types of fractures.The results of treatment were evaluated by functions and X-ray examination of involved wrists.Results All the 37 patients were fol- lowed up regularly.Satisfied synostosis by X-ray had been acquired.The wrist functions were evaluated by the Gartland and Werley system to find excellent result in 26 cases,good in eight,fair in two,and poor in one,with the excellent and good rate of 92%.Conclusion For the treatment of comminuted distal radial fractures,open intracapsular reduction can obtain fast fracture healing and recovery of wrist joint function.

Objective To investigate the possible mechanism of the gap junctional influence on the change in permeability of the blood-brain barrier(BBB)after reperfusion subsequent to cerebral ischemia.Methods In the test laser scanning confocal microscope(LSCM)was used to investigate the change of Cx43 levels and distribution.The MCAO/R model was induced using intraluminal suture technique first described by Longa with a little modification.A total of 60 Wistar rats were divided into 4 groups:the sham-operation group,control group,octanol-treatment group and DMSO vehicle control group. Control group were further divided into seven subgroups at different time points of reperfusion after middle cerebral artery occlusion.To observe the change in permeability of BBB,Evans blue(EB)in the brain tissue was surveyed by the means of EB fluorescent quantitation.Octanol-treatment group and DMSO vehicle control group were done at the point of the peak of permeability of BBB.Octanol,the specific blocker for gap junctions(GJ)was used in an intervention study.To compare the amount of EB with the same point of groups,the influence of octanol on BBB permeability was investigated.Results At 3 h of reperfusion after cerebral ischemia for 2 h,the permeability of BBB began to increase,reached the peak at 24 h of reperfusion and was still elevated at 72 h.The Cx43 expression formed into bigger plague and remained linear disposition in the penumbra after reperfusion subsequent to cerebral ischemia.Octanol group was done at 24 h of reperfusion after cerebral ischemia.The amount of EB of octanol group((4.924?0.296)?g/g)was significantly lower than that of corresponding operation control group(5.543?0.506)?g/g.Conclusions (1)Cx43 expression is concentrated around vessels in brain.The Cx43 forms into bigger plague and the function maybe strengthens after reperfusion.Gap junction might aggravate the disruption of BBB.(2) Octanol,the specific blocker of gap junctions,could effectively prevent the permeability of BBB from increasing and has a protective effect on BBB.

The main objective of this research is to investigate the effects of astragaloside IV, calycosin separately glucoside, formononetin on oxidative stress in Chang Liver cells induced by H2O2. In the experiments, Chang Liver cells (a kind of normal human hepatocytes) were used as the research object, bifendate which has a clear hepatoprotective effect was used as the positive control drug, then the oxidative damage model of Chang Liver cells were established by H2O2. Cells were divided into six groups: blank control group, oxidative stress group, astragaloside IV group, calycosin separately glucoside group, formononetin group and positive control group. Then endogenous antioxidant system related indexes were detected by micro plate and colorimetric method; intracellular reactive oxygen species (ROS) were detected by DCFH-DA fluorescent probe; and the expressions of CYP2E1 were evaluated by liver microsomes, mRNA, and protein, respectively with spectrophotometry, Real-time PCR method, and Western blot technique. Results showed that H2O2 decreased antioxidant activity, and increased ROS level and expression of CYP2E1. The above oxidative stress status had been changed with protections of the three components of Astragalus membranaceus (compared with oxidative stress group, P < 0.05, P < 0.01), which taken as a whole had equivalent effects as the drug of positive control group( bifendate). Taken together, three Astragalus membranaceus ingredients all had significant or extremely significant inhibiting effects on oxidative damaged Chang Liver cells which were induced by H2O2, and the oxidative damage of Chang Liver cells had been relieved.
Astragalus membranaceus ; chemistry ; Cells, Cultured ; Cytochrome P-450 CYP2E1 ; metabolism ; Humans ; Isoflavones ; pharmacology ; Liver ; drug effects ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Saponins ; pharmacology ; Triterpenes ; pharmacology

Objective To investigate the effects of enteral nutrition support with different doses of glutamine on nutritional status and gastrointestinal function in elderly critically ill patients.Methods Totally 90 critically ill patients were randomly divided into three group:the control group without glutamine (group A),enteral nutrition with low glutamine [0.3 g/(kg· d)] (group B),and high glutamine [0.6 g/(kg· d)] groups (group C).Fasting blood samples were collected on days 1,7,and 14 after the initiation of study,and then the indicators including serum diamine oxidase,glutamine,transferin (TF),prealbumin (PA),hemoglobin (HGB),albunin,and nitrogen balance were determined.In addition,the gastrointestinal complications including bloating,diarrhea,and gastric retention were recorded.Results On the 7th and 14th days,the serum glutamine levels in groups B and C were (1 886.8 ±420.5),(2 228.6 ±440.2) μg/L;(1 889.6 ± 436.1),(2 174.3 ± 440.8) μg/L,respectively,which were significantly higher than those in group A [(1 612.0 ±493.5),(1 869.7 ±559.8) μg/L] (P =0.027,P =0.008).The serum diamine oxidase levels were also significantly lower in group B [(2 310 ± 1 271),(1 602.5 ± 1 137.9) U/L] and group C [(2 076.3 ±567),(1 586.3 ±530.9) U/L] than in group A [(3 250 ±923),(2 476 ±862) U/L] (P =0.000,P =0.000).The serum TF and PA levels were significantly increased on the 7th day (P =0.023,P =0.047),and the HGB was significantly higher on 14th day (P =0.003),The number of patients who had undergone successful implementation of enteral nutrition were 4 and 3 in groups B and C,and the number of patients who had achieved the target volume of enterral nutrition was 25 and 27 in groups B and C,which were significantly larger than those in group A (12 and 13,respectively) (P =0.008,P =0.000).The gastrointestinal complication was also significantly decreased after the administration of enterral nutrition with glutamine.Conclusions Enteral nutrition with glutamine can improve intestinal mueosa barrier and nutritional status in elderly critically ill patients.Thus,it helps to reduce gastrointestinal complications and transition time of total enteral nutrition.

OBJECTIVETo study whether acupressure could relieve urinary retention after radical hysterectomy in cervical cancer patients.

METHODSA randomized controlled prospective double-blinded trial was carried out in 107 urinary retention patients undergoing grade III radical hysterectomy. They were assigned to Group A (positive acupoints, 40 cases), Group B (negative acupoints, 32 cases) , and Group C (with no acupoints, 35 cases). All patients received protective 115 000 potassium permanganate sitz bath, 15 - 20 min each time, 3 times per day. Patients in Group A received acupressure at positive points [liniao point and Qihai (RN6)] combined points by syndrome typing [Guanyuan (RN4) , Zhongji (RN3) , Shenshu (BL23) , Zusanli (ST36), Sanyinjiao (SP6), and Taixi (K13)]. Patients in Group B received negative acupressure at sham-acupoints (for adjusting gastrointestinal functions). Patients in Group C only received conventional sitz bath. All medication was performed 3 times per day, 7 days as one therapeutic course, 21 days in total. The residual urine volume was detected. The recovery time for bladder function was recorded. The average residual urine volume was also recorded at day 7, 14, and 21.

RESULTSCompared with Group B and C, the time for ureter retention was shortened for mild and severe CKD patients in Group A (P <0. 01). The residual urine volume was also lessened for mild and severe CKD patients in Group A at day 7, 14, and 21 (P <0.01).

CONCLUSIONCervical cancer patients could relieve urinary retention by self-acupressure after radical hysterectomy.

Acupressure ; Acupuncture Points ; Female ; Humans ; Hysterectomy ; Prospective Studies ; Urinary Bladder ; Urinary Retention ; therapy ; Uterine Cervical Neoplasms ; therapy

Objective To study the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with biliary and pancreatic diseases under the concept of enhanced recovery after surgery (ERAS). Methods 320 patients were enrolled in ERCP operation. Both ERAS elderly group (experimental group A, n = 58, above 75 years) and young and middle-aged group (control group B, n=202,below 60 years)underwent enhanced recovery after surgery,meanwhile traditional elderly group(control group C, n = 60, above 75 years) received traditional perioperative management. It had compared multiple clinical indexes between group A with B and group A with C during the preoperative, intraoperative, and postoperative period. Results The incidence rate of cholangiocarcinoma, multiple complications, nutrition screening ≥ 3 points, ASA scored III degree and Child-Pugh scored A-level in preoperative ERAS elderly patients were higher than that of the young and middle-aged group (P < 0.05); And its incidence rate of nausea and vomiting and abdominal pain,nutritional screening < 3 points and ASA scored I degree were lower than that of the middle-aged group (P < 0.05);the fasting and water- deprivation time of the ERAS elderly group was shorter than that of the traditional elderly group (P < 0.05). The intraoperative operation time of the elderly ERAS group was slightly longer than that of the traditional elderly group (P < 0.05). The duration of electrocardiographic monitoring and the first aerofluxus time of the elderly patients with ERAS were longer than that of the young and middle-aged group (P < 0.05). The success, failure rate, and complication rate of the elderly patients with ERAS were 91.38% (53/58) and 8.62% (5 /58), 3.45% (2/58), meanwhile the young and middle-aged group were 96.53% (195/202), 3.47% (7/202), and 4.95% (10/202), and with no statistical difference (P > 0.05). The mild pain in ERAS elderly group was more than that of in traditional elderly group, while the moderate, and severe pain was less than that of traditional elderly group (P < 0.05); The opioid use rate, endoscopic nasobiliary indwelling, first-time ambulation and aerofluxus, total hospitalization, and postoperative hospitalization time of ERAS elderly group was less than the traditional elderly group (P < 0.05). Conclusions With ERAS, the treatment effect of ERCP in elderly patients is similar to that in young and middle-aged people, and it has good safety and effectiveness.