The hypothalamo-pituitary-adrenal (HPA) axis modulates the inflammatory response during sepsis.Macrophage migration inhibitory factor (MIF) is a unique cytokine and critical mediator of host defenses in sepsis and septic shock.MIF counteracts the anti-inflammatory activity of glucocorticoid (GC).The interaction of GC and MIF might cause adrenal insufficiency.MIF could be a valuable clinical marker of adrenal insufficiency in sepsis.

Objective To assess the relationship between single nucleotide polymorphisms of FcεRIαgene and atopic dermatitis. Methods Genomic DNA samples were extracted from peripheral blood of 97 patients with atopic dermatitis and 283 normal human controls. The polymorphism at the distal promoter region of FcεRIα gene was determined by PCR-ligase detection reaction assay followed by gene sequencing. Results A G/T polymorphism was observed at position rs61828219 in the promoter region of FcεRIα gene, while all the tested individuals were homozygous for T/T at position rs12135235 and A/A at position rs36233780 in the promoter region of FcεRIα gene. The mutation frequency at position rs61828219 was 1.04% and 2.17% in patients with AD and normal human controls, respectively (both P ＞ 0.05). Conclusions In the Chinese Han population, there is a G/T polymorphism at position rs61828219 in FcεRIα gene promoter region, which is unlikely related to the development of AD; however, no polymorphism is detected at position rs12135235 or rs36233780.

OBJECTIVETo investigate the female sexual dysfunction (FSD) in type 2 diabetes patients, by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index (FSFI).

METHODS115 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds. Their sexual functions were evaluated with FSFI. Metabolic parameters such as body mass index, blood lipid profile, hemoglobin A1C, plasma glucose were also collected.

RESULTSTotal score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls (18.27±8.96 vs. 23.02±5.78, P=0.000). Scores of the FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, pain) of the type 2 diabetic group were also lower than those of the control group. According to the FSD criterion (FSFI<25) available in China, the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group (79.2%vs. 55.0%, P<0.001). These trends seemed more prominent in pre-menopause subgroups. The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD. Body Mass Index (BMI) also had influence in the diabetes group.

CONCLUSIONFindings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts, especially in pre-menopause participants.

Adult ; Asian Continental Ancestry Group ; Diabetes Mellitus, Type 2 ; complications ; Female ; Humans ; Middle Aged ; Sexual Dysfunction, Physiological ; etiology

Background: Acute mastitis is an acute infectious disease of breast. Antibiotic treatment is often unable to obtain a good effect, and we should actively look for a safe and effective non-drug therapy. Objective: To validate the clinical efficacy of kneading and dispersing manipulation in treatment of early-stage acute mastitis. Design, setting, participants and interventions: According to the multicenter randomized controlled trial design, 198 cases of acute mastitis from Yueyang Hospital of Integrated Traditional Chinese Medicine, Longhua Hospital, and Shanghai Yangpu Maternity and Child Health Hospital were randomly divided into treatment group and control group. There were 99 cases in each group. Patients in the treatment group were only treated with manipulation, and cefradine was orally administered to patients in the control group. Main outcome measures: The local breast lump size, clinical symptoms and the adverse reactions in the two groups were observed before and after the treatment. Results: The total response rates in the treatment and control group were 95.92% (94/98) and 80% (76/95) respectively. There was a significant difference in the total response rate between the two groups (P<0.05). There were significant differences in the score of breast lump size, and the score of signs and symptoms between the two groups (P<0.05). Conclusion: Kneading and dispersing manipulation has certain effects on early-stage acute mastitis, and the therapy is safe and repeatable.

ObjectiveTo assess the relationship between serum macrophage migration inhibitory factor (MIF) and sepsis in children with hematologic malignancy.Methods( 1 ) An observational study was performed in a university pediatric intensive care unit.Forty-one children were enrolled in our study,and were divided into two groups:sepsis group (27 cases) and non sepsis group ( 14 cases).(2) Serum samples were taken in the both two groups in 24 h after they were admitted in hospital.Clinical and laboratory parameters,including the levels of serum MIF,cortisol,corticotropin releasing hormone ( CRH),and ferritin were measured and compared between the two groups.Multiple linear regression analysis was used to assess the relationship between MIF and CRH,cortisol and pediatric critical illness score (PCIS).ResultsThe level of MIF was significantly elevated in the sepsis group[ (5 022.71 ± 3 915.82) pg/ml] than that of non sepsis group[ ( 1 722.81 ± 1 738.53) pg/ml] (P =0.001 ).Multiple linear regression analysis showed that CRH as well as PCIS were the correlative factors of MIF( t =- 2.830,P =0.009; t =2.852,P =0.009 ).The higher CRH concentration,the lower PCIS score,and the higher MIF was.ConclusionThe level of serum MIF could reflect the severity of children with hematologic malignancy complicated with sepsis.The higher MIF concentration,the lower PCIS score,then the disease is more serious.To some extent,serum MIF is related with the adrenocortical function of sepsis children.

OBJECTIVETo investigate the effect of four traditional Chinese medicines distributed along lung meridian, namely Ephedrae Hebra, Zingiberis Rhizoma, Scutellariae Radix and Mori Cortex, on TLR2 and NF-κB expressions in mice with lung heat syndrome, in order to study the intervention effect of the four traditional Chinese medicines (TCMs) on the lung heat syndrome.

METHODOne hundred KM mice were randomly divided into the normal control group, the model group, the Ephedrae Hebra group, the Zingiberis Rhizoma group, the Scutellariae Radix group and the Mori Cortex group (20, 10 g x kg(-1)), nasally dripped with streptococcus pneumoniae to establish the mouse lung heat syndrome model, and then administered with different TCMs. The expressions of TLR2, NF-κB p65 proteins in lung tissues were analyzed by the immunohistochemical method. The expressions of TLR2, NF-κB p65 mRNA were measured by real time PCR.

RESULTCompared with the normal control group, the expressions of TLR2 and NF-κB p65 proteins in lung tissues in the model group were higher (P < 0.01), and the expressions of TLR2 and NF-κB p65 mRNA in lung tissues were up-regulated (P < 0.01 or P < 0.05). Compared with the model group, Ephedrae Hebra high and low dose groups, the Zingiberis Rhizoma low dose group and the Scutellariae Radix high dose group showed decreased expression of TLR2 protein (P < 0.05 or P < 0.01); Ephedrae Hebra high and low dose groups, the Zingiberis Rhizoma low dose group, Scutellariae Radix high and low dose groups and Mori Cortex high and low dose groups showed reduced expression of NF-κB p65 protein (P < 0.05 or P < 0.01). Ephedrae Hebra high and low dose groups, Zingiberis Rhizoma high and low dose groups, Scutellariae Radix high dose group and Mori Cortex high dose group showed down-regulated expression of TLR2 mRNA (P < 0.01 or P < 0.05).

CONCLUSIONEphedrae Hebra, Zingiberis Rhizoma, Scutellariae Radix and Mori Cortex can induce the TLR2/NF-κB inflammatory signal pathways by down-regulating the expressions of TLR2 and NF-κB p65 in protein and mRNA, so as to alleviate the lung tissue injury in mice with lung heat syndrome.

Animals ; Down-Regulation ; drug effects ; Drugs, Chinese Herbal ; classification ; pharmacology ; Female ; Gene Expression ; drug effects ; Immunohistochemistry ; Lung ; drug effects ; metabolism ; microbiology ; Male ; Medicine, Chinese Traditional ; methods ; Meridians ; Mice ; Phytotherapy ; methods ; Plants, Medicinal ; chemistry ; classification ; Pneumonia, Pneumococcal ; drug therapy ; genetics ; metabolism ; Random Allocation ; Reverse Transcriptase Polymerase Chain Reaction ; Scutellaria baicalensis ; chemistry ; Species Specificity ; Syndrome ; Toll-Like Receptor 2 ; genetics ; metabolism ; Transcription Factor RelA ; genetics ; metabolism

Objective To compared the reliability and validity of the application of two consciousness assessment scales in neurosurgical patients by Full Outline of Unresponsiveness Score Coma Scale (FOUR) and the Glasgow Coma Scale (GCS), and provide the effective evaluation for the consciousness of the nerve severe patients. Methods A total of 100 neurological intensive patients from Nanfang Hospital, Southern Medical University were enrolled and the consciousness was evaluated by FOUR and GCS. The reliability and validity of these scales were evaluated and compared by the following method such as Cronbach αcoefficient, the inter-rater agreement,content validity index (CVI) and the receiver operating characteristic curve (ROC) which used to predict the discrimination of prognosis.The important experimental indexes of blood of the degree of brain injury were collected in the same period:S-100 B protein and neuron specific enolization enzymes (NSE). Results The Cronbach α coefficient was 0.811 (FOUR) and 0.923(GCS). The overall rater agreement was excellent with an intraclass correlation coefficients of 0.972 (FOUR) and 0.979(GCS). CVI was 0.965 (FOUR) and 0.973 (GCS). Both scales had better distinguish and predictive abilities for the poor prognosis.The area under the curve for mortality was 0.938 for the FOUR and 0.932 for the GCS. The best cut-off values for predicting poor prognosis were FOUR of 12 and GCS of 11. For the FOUR, the correlation coefficient was-0.324(P<0.05) with the level of NSE,-0.427(P<0.01) with the level of S-100B protein. For the GCS,the correlation coefficient was-0.316 (P<0.05) with the level of NSE,-0.395 (P<0.01) with the level of S-100B protein. Conclusions Both FOUR and GCS are a reliable scale for evaluating the level of consciousness in neurosurgical patients. The GCS is familiar with the medical staff while the FOUR is more adapted to assess the patients with tracheotomy or intubated and which more easy to remember and learn by medical staff of neurosurgery department.

Objective To investigate the clinical value of amplitude integrated electroencephalogram on early diagnosis and prognosis evaluation of brain injury caused by neonatal asphyxia.Methods A total of 34 full-term asphyxiated neonates(asphyxia group)hospitalized in NICU of our hospital from January 2015 to September 2015 were selected;meanwhile,34 full-term healthy infants(control group)of the same term were selected.All cases were monitored for the activities of aEEG background,sleep-awakening cycle(SWC)and epileptic activity(SA)within 6 hours after birth.Meanwhile,the relationships between various indexes and asphyxia degree and brain injury were analyzed.Results The electroencephalogram of the asphyxia group was 52.9％and the rate of SWC was 58.8％,which were lower than those of the control group,and the difference had statistic significance(P<0.05).Meanwhile,neonates with epileptic activity in asphyxia group accounted for 11.8％,which was higher than that of control group significantly(P<0.05).Conclusion The AEEG changes of neonates at early period after birth are closely related to perinatal asphyxia and brain injury after asphyxia.The application of amplitude integrated electroencephalogram has an important significance on early diagnosis of neonatal asphyxia.

Objective To explore the safety and therapeutic efficiency of continuous renal replacement therapy(CRRT) without anticoagulation for critically ill children with high risk of bleeding.Methods We retrospectively analyzed 51 patients undergoing bedside CRRT in the PICU of our hospital from December 2007 to July 2015.Patients were divided into two groups induding CRRT with anticoagulation(n=33) or without anticoagulation (n=18).The therapeutic efficiency and complications were compared between two grous.Results Totally 168 CRRT circuits were performed in these 51 patients including 62 (36.9％)circuits without anticoagulation in 18 patients with high risk of bleeding and 106(63.1％) with anticoagulation by heparin.The circuits life of CRRT without anticoagulation was (12.31±6.64) h,which was shorter than that of CRRT with anticoagulation [(17.43±9.97)h] (P＜0.001).The levels of blood creatinine,blood urea nitrogen,C-reactive protein,and lactate significantly improved after both therapies (P＜0.05).PT and APTT did not change in CRRT without anticoagulation for hemorrhagic complications(P＞0.05).APTT[(52.36±5.00)s vs.(76.48±9.02)s,P=0.013] and PLT[(127.3±20.85)×109/L vs.(95.52±15.46)×109/L,P=0.041]were significantly longer in CRRT with anticoagulation by heparin compared with those before treatment.Conclusion CRRT without anticoagulation reduces bleeding risks and achieves an acceptable circuit life.The strategy can be applied as an alternative to critically ill children at high risks of bleeding who need continuous blood purification.

Objective To describe the prevalence of aggressive behavior among preschool children and its related family factors.Methods 1234 preschool children in ten kindergartens were rated on their aggressive behavior by their parents,using Child Behavior Checklist(CBCI),Parent Behavior Inventory(PBI)and a general questionnaire.Results The overall prevalence of aggressive behavior among preschool children was 12.9％(95％ CI:11.0-15.0)according to the CBCL assessment,with the rate being slight higher(13.7％,93/680)in boys than in girls(11.9％,66/554).Data from logistic regression analysis showed that parents' hostile/coercive parenting style(OR=2.396,95％CI:1.636-3.510)and inconsistent parenting attitude between parents and grandparents(OR=1.867,95％ CI:1.287-2.710)would lead to more aggressive behaviors in preschool children.Compared with childen without difficulty in falling asleep,those who often(OR=3.415,95％ CI:1.901-6.135)or sometimes(OR=2.147,95％ CI:1.256-3.671)had problem falling asleep at night had more aggressive behaviors.On the other hand,factors as:watching TV less than 1 hour each day (OR=0.252,95％ CI:0.136-0.467),father in older age(OR=0.703,95％ CI:0.503-0.983)and participating in regular outdoor activitiess(OR=0.6 1 7,95％CI:0.399-0.955)were protective factors to the aggressive behaviors of the children.Conclusion The prevalence of aggressive behavior in preschool children was high which called for more attention.Intervention programs targeting the family should consider the influencing factors as ways of parenting,consistent attitude on parenting in the family etc.to reduce the occurrence of aggressive behavior among preschool children.