Objective To observe the effectiveness of Antithymocyte globulin/antilymphocyte globulin(ATG/ALG)in the treatment of nonsevere aplastie anemia(NSAA)patients who didn't respond to cyclosporine A(CsA)or relapsed and review the literature.Methods We administered ATG/ALG to 5 NSAA patients who relapsed or showed no re- sponse after CsA therapy.Results 3 patients were cured,2 patients improved,4 patients became transfusion inde- pendent in 90 days,none relapsed or progressed to clonal disease.Conclusion Those NSAA patients who relapsed or showed no response after CsA therapy should be asministered ATG/ALG,so as to reduce transfusion complications and prevent sustained immune attack to the bone marrow.

This study examined the expressions of human serum tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their clinical significance. The serum TF and TFPI levels were detected by ELISA in 28 allo-HSCT recipients before and after the transplantation and the changes of TF and TFPI levels were dynamically monitored at different phases of the disease. No significant differences in the serum TF and TFPI levels were found in allo-HSCT recipients in the absence of aGVHD or with grade I aGVHD before and after the transplantation. The levels of serum TF and TFPI were substantially increased in the patients with gradeII aGVHD at the peak of aGVHD (P<0.05) and they were even higher in the patients with grade III-IV aGVHD (P<0.01). When the conditions became stable after treatment with immunosuppressive agents, the serum TFPI level was decreased to the baseline level (P>0.05) and the TF level was lowered but still higher than the baseline level (P<0.05). It was concluded that the levels of serum TF and TFPI were increased significantly in the patients with grade II-IV aGVHD after allo-HSCT and decreased markedly after the treatment. Monitoring the levels of serum TF and TFPI in the patients with allo-HSCT is important to predict the occurrence, outcome and prognosis of aGVHD.

Objective To investigate the dynamic changes of cerebral blood flow defined bytranscranial color Doppler (TCD) and their correlation with the severity and prognosis of acute ischemicstroke. Methods Fifty-six consecutive patients with the primary onset of acute ischemic strokereceived dynamic examinations with TCD upon admission and on days 2, 4, 7, 14 and 28 following theonset, and the mean blood flow velocity and pulsatility index were recorded. Results TCDexaminations upon admission revealed high abnormal rate. The mean blood flow velocity of the middlecerebral artery (VmMCA) on the lesion side was significantly lower than that on the contralateral side andthat of the control group. The blood flow velocity of the anterior cerebral artery (VmACA) on the lesion sidewas significantly increased compared with that on the contralateral side and that of the control group.VmMCA of main stem occlusion group {23.45 [7.55,38.72] cm/s}, central branch infarction group {52.53[45.56,66.93] cm/s}, and cortical branch of cerebral arteries infarction group {38.44[31.67,52.45] cm/s}was significantly lower than that of the control group {66.51 [56.64,71.43] cm/s}. VmMCA graduallyincreased in these patients after the treatment, showing significant difference from that measured uponadmission. The PI of the middle cerebral artery increased after admission, with significant difference fromthat recorded on admission and that of the control group. Conclusion TCD has high diagnostic valuefor ischernic stroke and may help evaluate the severity of the condition and the prognosis of the patients.

Objective To explore the clinical significance of EEG and CT presentations in the patients with acute ischemic stroke. Methods Fifty-six consecutive patients with acute ischemic stroke admitted immediately after the onset were enrolled in this study.Thefindings bYCT,EEG,brain electrical activity mapping(BEAM),examinations of somatosensory evoked potentials(SEPs)and motor evoked potentials(MEPs)to transcranial magnetic stimulation, and the scores of modified Edinburgh-Scandinavia stroke scale(MESSS)and Barthel Index(BI)were comparatively analyzed in these patients. Results The location of the cerebral foci with EEG abnormalities were basically consistent with the lesions indentified by CT.but the range of the lesions defined by the two modalities showed some discrepancies.There Was statistically significant difference in SEP and MEP between the injured and uninjured sides(P<0.05).There was apositive correlation between MESSS on admission and BI on day 28 in hospital(r=0.58,P<0.05). Conclusion CT and cerebral electrophysiological examination provide valuable assistance in early diagnosis of acute ischemic stroke.

OBJECTIVETo evaluate the efficacy and safety of aripiprazole in the treatment of children with Tourette syndrome.

METHODA prospective, multi-center, controlled clinical trial was conducted in 195 children aged 5-17 years with Tourette syndrome. The patients were assigned to two groups: aripiprazole group (n=98) and tiapride group (n=97), with the treatment dosage of 5-25 mg/d and 100-500 mg/d, respectively. After 12 weeks treatment, the clinical efficacy was assessed by the Yale Global Tic Severity Scale (YGTSS) score, and adverse reactions were observed by side effects symptoms scale, blood biochemical indexes, and electrocardiography.

RESULTSignificant pre- and post-treatment differences were ascertained for motor tic, phonic tic, function damage and total scores of YGTSS in the both groups from the second week of treatment (P<0.0001). Compared with the tiapride group, the aripiprazole group showed a more significantly decreased function damage score of YGTSS by the second week of treatment (P<0.05). After 12 weeks treatment, total scores of YGTSS in the aripiprazole group decreased from 53.74±15.71 at baseline to 24.36±16.38, while in the tiapride group from 51.66±13.63 to 23.26±15.31. The mean reduction scores of YGTSS were 29.38 in the aripiprazole group and 28.40 in the tiapride group at the end of treatment, and the clinical response rates were 60.21% and 63.92%, respectively. There were no significant differences between the 2 groups (P>0.05). The incidence of adverse reactions was similar in the aripiprazole and tiapride groups, with 29.6% and 27.8% respectively. There were no significant differences in the incidence of adverse reactions between aripiprazole and tiapride groups and no severe adverse events were found in either group.

CONCLUSIONThe results showed that aripiprazole showed similar therapeutic effect to tiapride in treatment of children with Tourette syndrome. Aripiprazole was safe and well tolerated in Chinese population, and can be considered as a new valid option for the treatment of tic disorders.

Adolescent ; Antipsychotic Agents ; therapeutic use ; Aripiprazole ; Child ; Child, Preschool ; Female ; Humans ; Male ; Piperazines ; therapeutic use ; Prospective Studies ; Quinolones ; therapeutic use ; Tiapamil Hydrochloride ; therapeutic use ; Tourette Syndrome ; drug therapy ; Treatment Outcome

OBJECTIVETo evaluate their long-term outcome and the efficacy and economic significance of antiviral drugs by investigating the long-term health-related quality of life (HQL) in chronic hepatitis B (CHB) patients.

METHODSThe HQL of 101 CHB patients with biopsy-proven 6 to 18 years ago and 105 persons of general population as control was studied with revised SF-36 questionnaire.

RESULTSThe HQL in CHB patients was lower than that in general population in physical functioning, role physical, general health, mental health, and specific symptoms (mu > or = 2.10, P<0.05).

CONCLUSIONSThe long-term HQL in chronic hepatitis B patients is poor.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Cost of Illness ; Female ; Follow-Up Studies ; Hepatitis B, Chronic ; drug therapy ; economics ; Humans ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires

Objective: To explore the relationship between psychological resilience and cognitive bias towards school violence in grade 3-5 primary school students in Luzhou city, so as to provide scientific basis for prevention and control of school violence in primary school students. Methods: Students from grade 3-5 in primary schools in Luzhou were selected through stratified cluster random sampling method and were investigated with questionnaire survey. Results: A total of 5 976 valid questionnaires were included, with an average score of psychological resilience (40.08±8.05) and an average score of school violence cognition (62.55±6.38). Multivariate results showed that psychological resilience was an independently associated with school violence perception (OR=1.04, P<0.01). The awareness of campus violence increased with resilience score. In addition, public school (OR=0.45) was associated with low awareness of school violence; senior grades (OR=1.77), girls (OR=1.20), and a greater number of friends(OR=1.37), student cadre(OR=1.37), middle/upper score in class(OR=2.13), no game playing(OR=1.33), no off-campus wandering(OR=1.78), timely parenting (OR=1.45) was associated with high awareness of school violence(P<0.05). Conclusion Psychological resilience positively correlates with cognition bias towards school violence. The higher the psychological resilience, the more positive perception of campus violence. Family, school and community-based interventions to enhance the resilience of students, increasing awareness towards school violence and ultimately reducing potential adverse impacts of school violence.

This study examined the expressions of human serum tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their clinical significance. The serum TFand TFPI levels were detected by ELISA in 28 allo-HSCT recipients before and after the transplantation and the changes of TF and TFPI levels were dynamically monitored at different phases of the disease. No significant differences in the serum TF and TFPI levels were found in allo-HSCT recipients in the absence of aGVHD or with grade Ⅰ aGVHD before and after the transplantation. The levels of serum TF and TFPI were substantially increased in the patients with grade Ⅱ aGVHD at the peak of aGVHD (P＜0.05) and they were even higher in the patients with grade Ⅲ-Ⅳ aGVHD (P＜0.01). When the conditions became stable after treatment with immunosuppressive agents,the serum TFPI level was decreased to the baseline level (P＞0.05) and the TF level was lowered but still higher than the baseline level (P＜0.05). It was concluded that the levels of serum TF and TFPI were increased significantly in the patients with grade Ⅱ-Ⅳ aGVHD after allo-HSCT and decreased markedly after the treatment. Monitoring the levels of serum TF and TFPI in the patients with allo-HSCT is important to predict the occurrence,outcome and prognosis of aGVHD.

OBJECTIVETo investigate the relationship between the dendritic cell (DC) subsets and transcriptive factors, T-bet, GATA-3, and immune imbalance in acquired severe aplastic anemia (SAA).

METHODSThe DC1 (HLA-DR+Lin-CD11c+) and DC2 (HLA-DR+Lin-CD123+) in peripheral blood mononuclear cells (PBMNC) were measured with flow cytometry (FCM), the expressions of T-bet mRNA and GATA-3 mRNA in PBMNC with semiquantitative RT-PCR and the plasma level of IFN gamma and IL-4 with ELISA in 29 SAA patients and 16 healthy controls.

RESULTSThe percentages of DC1 in PBMNC were (0.44 +/- 0.24)% and (0.73 +/- 0.30)% in untreated and recovered SAA patients respectively, both were higher than that in controls (0.29 +/- 0.10)% (P < 0.05). The percentage of DC2 in the untreated cases was lower than that of recovered ones or controls [(0.18 +/- 0.14)% vs (0.28 +/- 0.20)% and (0.29 +/- 0.13)%] (P < 0.05). DC1/DC2 ratios were 3.45 +/- 2.71 and 2.90 +/- 0.95 in untreated and recovered groups respectively, both were higher than that in controls (1.15 +/- 0.56) (P < 0.05). No statistic difference in DC1/DC2 ratio was found between untreated and recovered patients (P < 0.05). The relative mRNA expression levels of transcriptive factor T-bet were 0.37 +/- 0.07, 0.20 +/- 0.07 and 0.17 +/- 0.05 in the above 3 groups, respectively, untreated group being higher than that of recovered group or healthy controls (P < 0.05). There was no statistic difference of GATA-3 expression among the 3 groups (P > 0.05). T-bet/GATA-3 ratio was 0.72 +/- 0.13 in untreated group, being higher than that of recovered group (0.33 +/- 0.08) or controls (0.35 +/- 0.11). The plasma level of IFN gamma in the untreated group was (50.9 +/- 1.1) ng/L, which was higher than that of recovered group [(49.7 +/- 0.9) ng/L] or controls [(49.7 +/- 0.7) ng/L]. There was significant positive correlations between T-bet and DC1/DC2 ratio (r = 0.445, P < 0.01), as well as between T-bet and IFN gamma (r = 0.402, P < 0.01).

CONCLUSIONEither DC1/DC2 or T-bet/GATA-3 ratio might become an index to estimate immune imbalance. High-expressed T-bet was related to the progress of SAA. In patients with SAA, DC1/DC2 ratio returns to normal range later than that of routine blood test does, indicating that immunosuppressive therapy should not be withdrawn too earlier.

Adolescent ; Adult ; Anemia, Aplastic ; blood ; immunology ; Child ; Dendritic Cells ; immunology ; Female ; GATA3 Transcription Factor ; blood ; genetics ; Humans ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male ; Middle Aged ; RNA, Messenger ; genetics ; T-Box Domain Proteins ; blood ; genetics ; Young Adult