Animals ; Aortitis ; pathology ; Biopsy ; Dendritic Cells ; pathology ; Diagnosis, Differential ; Giant Cell Arteritis ; drug therapy ; etiology ; metabolism ; pathology ; Glucocorticoids ; therapeutic use ; Humans ; Interleukin-12 ; metabolism ; Oxidative Stress ; Polymyalgia Rheumatica ; pathology ; Temporal Arteries ; pathology

Objective:To evaluate the therapeutic effects of capsule of Biqi Capsule and VitB on lubar intervertebral disc protrusion(LIDP).Methods:78 Patients with LIDP were divided randomly into 2 groups:treatment and control group.39 Patients in treatment group were treated with Biqi Capsule and FENG's bone-setting manipulation,39 patients in control group were treated with vitamine B and FENG's bone-setting manipulation.All patients were followed up for 1 month after treatment for 2 weeks and therapeutic effects were evaluated.Results:In treatment group,24 patients were cured,6 patients had remarkable effects,5 effective,4 ineffective.In control group,the data were 16,8,8,7 correspondly.The therapeutic effects in treatment group were obviously better than those of control group(P

Objective To analyze the clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis.Methods From Apr.2013 to Aug.2015,120 feet with severe hallux valgus were treated by operation in Beijing Friendship Hospital,Capital Medical University.Before operation,measured some angles,such as hallux valgus angle,intermetatarsal angle,proximal articular surficial intrinsic angle and so on in the two groups.And evaluated the patients condition by Maryland scale at the same time.Through the date,we make sure that there was no significant difference between the two groups before operation.According to the order of hospitalization,all patients were randomly divided into experimental group (n =60) and control group (n =60).The cases of experimental group were treated by Ludloff osteotomy and artificial joint replacement.The cases of control group were treated by Ludloff osteotomy and Akin osteotomy.We used the visual analogue scale,the core quality of life scale-36 and Maryland scale to record the date,such as pain,the range of motion and appearance of the metatarsophalangeal joint and the ability of daily life and sports before and after operation.Compared above categorical variables using paired T-test between before and after operation and using T-test between the two groups.Compared the rate of operative complications by Fisher's exact test between the two groups.Results Through the Maryland scale,the total excellent rate of the experimental group (91.7％) was higher than the total excellent rate of the control group (75.0％),with statistically significant (P ＜ 0.05).The operative complication rate of experimental group (1.7％) was lower than the control group (8.3％),but without statistically significant (P ＞0.05).The scores of quality of life of the experimental group after treatment were significantly higher than those of the control group,with statistically significant (P ＜ 0.05).The visual analogue scale pain score (1.61 ± 0.12) of the experimental group was significantly lower than the control group (3.68 ± 0.58),with statistically significant (P ＜ 0.05).Conclusion The clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis is better,high safety,less trauma and faster recovery.It is worthy of promotion and use.

Objective To study the clinical application of proportional assisted ventilation (PAV) in the treatment of neonatal respiratory failure.Method From March 2011 to October 2013,a retrospective study was conducted on newborns receiving ventilation therapy for respiratory failure.The newborns were assigned into PAV group and synchronized intermittent mandatory ventilation (SIMV) group.Arterial blood pH 、partial pressure of arterial oxygen (PaO2)、partial pressure of arterial carbon dioxide (PaCO2) and oxygenation index (OI) were compared at the time before ventilation and 2 h,6 h,12 h,24 h after ventilation.The frequency of sedative usage and average time of ventilation between the two groups were compared.Result A total of 30 cases were enrolled in the PAV group and the SIMV group respectively.Before ventilation,no statically significant differences existed on blood pH[(7.13 ± 0.12)、(7.14 ±0.11)],PaO2[(41.1 ±8.9),(40.8±8.8) mmHg],PaCO2[(76.4±12.6),(73.2±13.5) mmHg]and OI between the two groups (P ＞ 0.05).2 h after ventilation,the blood pH [(7.25 ± 0.17)、(7.23 ± 0.15)],PaO2 [(51.0 ± 5.6)、(48.6 ± 5.3) mmHg] and OI were significantly improved,while PaCO2 [(66.3 ± 8.7)、(64.0 ± 7.5) mmHg] decreased.Comparing with data before ventilation,those parameters were statistically improved at each time point after ventilation (P ＜ 0.01).But no statistically differences existed between the two groups at the same time (P ＞ 0.05).Sedatives were used (2.3 ± 1.2)times/case in PAV group and (3.9 ± 2.2) in SIMV group,with statistically differences between the two groups (P ＜ 0.05).Average duration of ventilation were (5.1 ± 1.9) d in PAV group and (5.4 ± 2.1) d in SIMV group,with no statistically differences between the two groups (P ＞ 0.05).Conclusion PAV is very effective in treating the neonatal respiratory failure and worth spreading.

Objective To investigate the changes of thyroid hormones in patients with peripartum car-diomyopathy. Methods Seventy-two patients with peripartum cardiomyopathy were consecutively enrolled and 72 healthy women who had normal delivery were regarded as control. Among all the subjects , free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in the serum and high sensitive C-reactive protein (hs-CRP), interferon-gamma (IFN-γ) and interleukin-4 (IL-4) in the plasma were measured. Results The levels of serum FT3 and FT4 in peripartum cardiomyopathy group were significantly higher than those in control group (P < 0.05). And the level of serum TSH in peripartum cardiomyopathy group was significantly low-er than that in control group (P < 0.05). There were 24 cases with hyperthyroidism in peripartum cardiomyopa-thy group while no patient in the control group had hyperthyroidism (P < 0.05). The levels of plasma hs-CRP and IFN-γ in peripartum cardiomyopathy group were significantly higher than those in the control group (P <0.05). And the level of IL-4 in peripartum cardiomyopathy group was significantly lower than that in the control group (P < 0.05). Conclusions Serum thyroid hormones elevated in patients with peripartum cardiomyopathy and its mechanism might be related to abnormal immune reaction.

Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

Objective To discuss the mechanism and characteristics of clinic presentation and neuropathology in idiopathic hypereosinophilic syndrome (IHES) encephalopathy. Methods IHES encephalopathy was diagnosed by clinical presentations,lab examinations,neurologic images,marrow and brain biopsy,then treated with corticosteroids and continuous follow-up. Results The IHES patient presented progressive limbs weakness and cognitive deficit with elevated eosinophil count. Results of lab examinations and bone marrow biopsy ruled out secondary eosinophilia and clonal eosinophilia such as eosinophilic leukemia.Brain magnetic resonance imaging (MRI) study showed multiple lesions in right frontal lobe, bilateral parietal and occipital lobe, presenting hypointensity in T1 weighted images,hyperintensity in T2 and fluid-attenuated inversion recovery weighed images. Brain biopsy showed proliferation of vascular membrane,small vessels stenosis,ischemia-induced morphological change and necrosis of neurons in the lesions.The patient was continuously treated with corticosteroids,and the situation was stabilized with follow-up.Conclusions IHES encephalopathy should be paid more attention in clinical practice of neurologists for its rarity. Brain vascular damages caused by elevated eosinophil may be an important pathophysiological mechanism of IHES encephalopathy,and corticosteroids or hydroxycarbamide should be used for the treatment.

Objective To determine the allelic frequency distribution and genetic parameters of nine non-CODIS DNA index systems of the short tandemrepeat (STR ) loci (D2S1772, D6S1043, D7S3048, D8S1132, D11S2368, D12S391, D13S325, D18S1364, and GATA198B05). Methods A total of 353 blood samples were collected, extracted, amplified, and analyzed fromunrelated healthy individuals of Han na-tionality in Hunan Province, China. Results O ne hundred and fourteen alleles were observed in the pop-ulation with corresponding allelic frequencies ranged from0.001 0 to 0.323 0. For all the nine non-CODIS STR loci, the observed genotypic data showed no significant deviations fromthe Hardy-W einberg equi-librium. The Ho, He, PIC, D P, and PE of the studied non-CODIS STR loci ranged from0.108 0 to 0.195 0, 0.805 0 to 0.892 0, 0.770 0 to 0.860 0, 0.925 0 to 0.966 0 and 0.607 0 to 0.780 0, respectively. Conclusion N ine non-CODIS STR loci have high degrees of polymorphisms, which may be useful in in-dividual forensic identification and parentage testing in forensic practice.

A 16-year-old male presented with a 11-year history of progressively enlarging erythema and crusting on the right cheek.Physical examination revealed an irregularly shaped,sharply marginated,dark erythematous patch sized 6 cm x 10 cm and plaques with mild verrucous proliferation.There were strip-like scar at the margin of lesions and multiple ulcers measuring 0.5 to 1 cm in diameter with firm crusts.No small jellycolored nodules were observed.Direct microscopy of multiple scrapings under the crusts showed many light brown,septate,branching and irregular hyphae.Olivaceous-black woolly colonies grew at 25 C and 35 C on Sabouraud's dextrose agar and potato dextrose agar; flask-shaped conidiogenous cells with funnel-shaped collarettes and ellipsoidal conidia arranged in flower-like shape were observed microscopically.PAS staining showed numerous septate and branching hyphae,pseudohyphae and yeast-like cells.There was a 99.73％ similarity in the species-specific rDNA sequence between the isolate and phialophora verrucosa standard strain CDC-B2152.The patient was diagnosed with cutaneous phaeohyphomycosis caused by Phialophora verrucosa.The lesion subsided after treatment with amphotericin B and itraconazole,but recurred after drug withdrawal.Itraconazole and terbinafine were administered for the retreatment of this patient.

Objective To analyze the mutations of GATA4 gene in Han Chinese patients with atrioventricular septal defect(AVSD)and investigate the association between GATA4 gene and pathogenesis. Methods Ninety-four Han Chinese patients with AVSD were recruited,including 23 patients with Down syndrome and 71 patients without. One hundred healthy age-matched Han children were used as the control. Blood samples were drawn. Encoding region and flanking introns of GATA4 gene were amplified using polymerase chain reaction. The mutations were detected by DNA fragment sequences analysis. Results Three novel missense mutations(c.106C ＞ G,p.P36A;c.259C ＞ T, p.P87S;c.504C ＞ A,p.D168E)of the GATA4 gene were identified in three patients with complete AVSD without Down syndrome,and a fourth novel missense mutation(c.1079A ＞ G,p.E360G)was noted in a patient with complete AVSD and Down syndrome. A polymorphism of the GATA4 gene(c.G99T,p.A33A)from six patients was detected. Conclusions The GATA4 gene might be involved in the etiology of AVSD by functional changes resulting from gene mutation. The low incidence of GATA4 gene mutations in patients with AVSD with or without Down syndrome might suggest that AVSD is a polygenetic disorder.