Background Uveal effusion syndrome is uncommon in clinic.To understand the clinical characteristics of uveal effusion syndrome is helpful for rescuing visual acuity of patient.Objective This study was to discuss the diagnosis,classification and surgical outcome of uveal effusion syndrome.Methods This was a descriptive study.The clinical data of 14 eys from 10 patients with uveal effusion syndrome,ineluding ophthalmologic examination,B-scan sonography,ultrasound biomicroscopy (UBM),fundus fluorescence angiography (FFA),indocyanine green angiography (ICGA),surgical treatment and prognosis,were retrospectively analyzed.The follow-up period was 6 months.Results The fundus findings of all impacted eyes showed bullous-shape retinal detachment (RD).B-scan sonography revealed retinal and choroidal detachment.A annular peripheral ciliochoroidal detachment was observed in the cases under the UBM.FFA exhibited leopard spots without any leakage from choroid into the subretinal space.ICGA demonstrated diffusely choroidal granular hyperfluorescence in the very early phase,which presented with an increasing intensity as time lapse until the late phase.Full-thickness sclerectomy was performed on 4 eyes of 2 patients and subscleral sclerectomy was performed in 1 eye of 1 patient,achieving a retinal anatomic reattachment after surgery.All of the patients finished the fellow-up.No recurrence of RD was seen during the followup duration.Conclusions Comprehensive preoperative evaluation,including ophthalmologic ultrasonography,MRI and CT,is crucial for accurate classification of uveal effusion syndrome and determine of proper management strategy.

Objective To investigate the clinical efficacy of kinetic rectification acupuncture in treating acute facial neuritis. Method Sixty patients with acute facial neuritis were randomized to observation and control groups. The observation group received kinetic rectification acupuncture and the control group, conventional acupuncture alone. Acupuncture was given five times a week, five times as one course. The therapeutic effects were evaluated after three courses of treatment. Result The total efficacy rate was 93.3% in the observation group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). The latencies and amplitudes of the frontal muscle, orbicularis oculi muscle and quadrate muscle of upper lip improved in the two groups after treatment and had statistically significant pre-/post-treatment differences (P < 0.01). There were statistically significant differences in the pre-/post-treatment difference values of the latencies and amplitudes of the frontal muscle and orbicularis oculi muscle (P<0.01) and no statistically significant difference in the pre-/post-treatment difference values of the latency and amplitude of the quadrate muscle of upper lip (P>0.05) between the two groups. Conclusion Kinetic rectification acupuncture has a marked therapeutic effect on acute facial neuritis. This study provides a particular therapeutic method for clinical practice.

Acupressure ; methods ; Adolescent ; Adult ; Cervical Vertebrae ; pathology ; Female ; Humans ; Male ; Spinal Curvatures ; pathology ; physiopathology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the impact of specific siRNA on survivin gene in transfected leukemia cells.

METHODThe small interfering RNA (siRNA) targeted survivin mRNA was synthesized in vitro and was transfected into K562 cell by Hiperfect into human leukemia cell line K562, which has high survivin expression level. The level of survivin mRNA expression was determined by quantitative reverse transcription polymerase chain reaction (RT-PCR) with SYBR GREEN I. The apoptosis index of cytotrophoblasts were determined and analyzed by FCM (Annexin V-FITC/PI staining methods). The cell proliferation was examined by MTT at 48 h and 72 h after transfection.

RESULTThe level of mRNA expression was significantly inhibited by the siRNA 48 h and 72 h after transfection, the suppression rate of survivin mRNA separately reached 85.21%, 94.35% mensurated by quantitative RT-PCR with SYBR GREEN I, cell proliferation was inhibited significantly by 45.02% and 50.88%, respectively, the apoptotic rate detected by Annexin V-FITC assay reached 12.28%and 21.55%, respectively.

CONCLUSIONThe chemosynthesized siRNA targeting survivin could significantly down-regulate survivin mRNA. Survivin siRNA was able to inhibit the proliferation of leukemia cell line K562. Survivin may become a new target for leukemia gene therapy.

Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Gene Silencing ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; K562 Cells ; RNA, Small Interfering ; pharmacology ; Transfection

The study was aimed to observe morphological characteristics and hematopoiesis function of bone marrow megakaryocyte in children patients with myelodysplastic syndrome (MDS), and analyse the cause and mechanism of thrombocytopenia. CD41 McAb immunohistochemical technique was used to detect micromegakaryocytes of bone marrow smear. Plasma clot culture and CD41 McAb immunohistochemical technique were used for the MK-colony forming assay. The colony formations of CFU-MK and BFU-MK were measured. The results showed that there was no significant difference of CFU-MK colony formation rate between groups of MDS and control. But, in 62.5% of children patients the colony formation rate of CFU-MK decreased, in 25% increased, and in 12.5% was normal while BFU-MK formation rate decreased in MDS group significantly. The number of micromegakaryocyte and the positive rate of type I lymphoid micromegakaryocyte were significantly higher than those of the control group. In conclusion, there may be two kinds of megakaryocyte clones in bone marrow of children patients with MDS. One is supposed to be pathologic and potentially malignant micromegakaryocytes, the another may be the normal megakaryocytic precursors. The thrombocytopenia in MDS patients induced by increase of pathologic MK leads to abnormal development and maturation of MK in bone marrow.
Adolescent ; Bone Marrow Cells ; pathology ; Child ; Child, Preschool ; Female ; Hematopoiesis ; Humans ; Infant ; Male ; Megakaryocytes ; pathology ; Myelodysplastic Syndromes ; blood ; pathology

OBJECTIVETo analyze the relationship between traditional classification and Lavin-Osband criteria on Langerhans cell histiocytosis (LCH) and to evaluate the importance of the criteria in clinical management and long-term prognosis of Lavin-Osband criteria.

METHODSFrom 1992 to 2003, 25 cases of LCH were studied. All cases were divided into four types by traditional classification and graded according to Lavin-Osband criteria simultaneously. All patients were analyzed with clinical manifestation, laboratory test, diagnoses, treatment and prognosis. The case numbers distributed in different Lavin-Osband criteria were summed up, and the advantage of the criteria was analyzed.

RESULTSThe clinical manifestations according to the traditional classification (four types) overlapped mostly. The age of onset of the disease, the number of involved organs and the function of organs were all considered in the Lavin-Osband criteria, which also contained the characters of the traditional classification and could classify the cases into different severities. So Lavin-Osband criteria could predict the outcome of LCH. According to the traditional classification there were 10 cases with type I LCH, which was all graded to the criteria III and IV (100%), and there were 8 (80%) of criteria IV and none of criteria I and II. The situation was called "low type high criteria". There were 6 cases belong to LCH-II, of them 3 (50%) graded to the criteria III and 1 to the other criteria (17%), respectively. There were 4 cases with LCH-III, of them 3 (75%) graded to the criteria I and II, 1 (25%) to the criteria III and none to the criteria IV. There were 5 cases with LCH-IV, of them 4 (80%) graded to the criteria I and II, 1 (20%) to the criteria III and none to the criteria IV. This situation was called "high type low criteria".

CONCLUSIONThe Lavin-Osband criteria seemed to be simple, clear and easy to be handled and related to the severity of the disease, which will simplify the diagnoses, help the early-treatment and judge the prognosis.

Child, Preschool ; Female ; Histiocytosis, Langerhans-Cell ; classification ; pathology ; Humans ; Infant ; Male ; Prognosis ; Severity of Illness Index

OBJECTIVETo investigate molecular epidemiologic features of rotaviruses circulating in Shanghai, China.

METHODSStool samples were collected from 1230 hospitalized children with community-acquired and nosocomially acquired diarrhea in Children's Hospital Affiliated to Fudan University between November 1, 1999 and December 31, 2001. Polyacrylamide gel electrophoresis (PAGE) was used to detect rotavirus genomic RNA and identify electropherotypes of group A rotavirus RNAs. Reverse transcription polymerase chain reaction (RT-PCR) was performed to amplify full length VP7 gene and dot blot hybridization was performed to identify rotavirus G serotypes using digoxigenin-labelled variable regions from VP7 genes as probes. These probes were amplified by PCR from recombinant plasmids containing full length G1, G2, G3 and G4 VP7 genes from rotavirus field strains detected in Beijing and digoxigenin labelled dUTP was integrated into the PCR products. The Kruskal-Wallis analysis of variance was employed to analyze whether there were significant differences in variables.

RESULTSOut of 1230 samples investigated, 493 (40.1%) were group A rotavirus gene positive by PAGE, among which 397 (80.5%) showed long electropherotypes, 55 (11.2%) showed short electropherotypes, 18 (3.7%) showed mixed electropherotypes which suggested that the children were co-infected by rotaviruses with different electropherotypes, 23 (4.7%) were non-typable because of degradation of some of the genomic RNA fragments. No group B or group C rotavirus was found. RT-PCRs were performed for 328 fecal specimens containing sufficient rotavirus RNAs and VP7 gene products were obtained from 254 (77.4%) samples. Dot blot hybridization showed serotype G1 accounted for 55.5% (141) of these samples, serotype G3 accounted for 27.6% (70), serotype G2 accounted for 9.4% (24), co-infection by 2 rotaviruses with different G types accounted for 6.3% (16), only 1 G4 was detected and 2 were non-typable. The genomic RNA patterns of all G2 strains were short and those of G1, G3 and G4 strains were long. There were no statistically significant differences for age distribution and clinical manifestations among those infants and children infected by rotaviruses with different G serotypes.

CONCLUSIONGroup A rotavirus is the major pathogen for diarrhea in infants and children in Shanghai during the period of Nov. 1999 to Dec. 2001. Rotaviruses with long electropherotype were dominant during these years. Serotypes G1 to G3 constituted 98.8% of all 254 strains tested, and G1 was the most common serotype followed by G3 and G2, whereas serotype G4 was seldom found. Some of the children were co-infected by rotaviruses with different G serotypes. Clinical manifestations were not related to the infecting rotavirus with different G serotypes.

Age Factors ; Antigens, Viral ; Capsid Proteins ; genetics ; metabolism ; Child, Preschool ; China ; epidemiology ; Data Collection ; Dysentery ; epidemiology ; etiology ; Electrophoresis, Polyacrylamide Gel ; Feces ; virology ; Female ; Humans ; Infant ; Male ; RNA, Viral ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Rotavirus ; classification ; genetics ; Rotavirus Infections ; complications ; epidemiology ; virology ; Serotyping

OBJECTIVEBone marrow megakaryocytes overly proliferate and abnormally develop among patients with idiopathic thrombocytopenic purpura (ITP). Previous studies showed that it resulted from the abnormal immune function of the body. But the changes in megakaryocytes, especially in micromegakaryocytes in this disease are unclear. The present study was designed to explore the growth and development status of megakaryocytes and the significance of changes in micromegakaryocytes in pediatric cases.

METHODSRoutine bone marrow smears assay and enzyme labeling for micromegakaryocytes with CD41 monoclonal antibody (McAb) were performed in 46 children with ITP. The level of platelet-associated immunoglobulin (PA-Ig) was measured with ELISA.

RESULTSAmong 46 children, 36 had acute ITP (AITP)and 10 chronic ITP (CITP). The number of megakaryocytes increased or was normal in 45 patients, but decreased only in 1 case of CITP. The positive rate of micromegakaryocytes and type I micromegakaryocytes was 98% (45/46) and 35% (16/46), respectively. The positive rate of type I micromegakaryocytes was higher in CITP (50%) cases than that in AITP (31%) cases, but the median of the other three types of micromegakaryocytes in CITP cases (159) was lower than that in the AITP cases (336). There was no relationship between the numbre of all types of megakaryocytes and the level of PA-Ig.

CONCLUSIONMajority of patients with ITP showed an increase in micromegakaryocytes, especially in type II, III and IV. The immune disturbance might not be the only reason for ITP. The abnormality of quality of megakaryocytes might be one of the potential causes for thrombocytopenia in some cases of ITP, especially in those of CITP. The appearance and the number of type I micromegakaryocytes might reflect the prognosis of cases of ITP.

Adolescent ; Blood Platelets ; immunology ; Cell Count ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulins ; analysis ; Infant ; Male ; Megakaryocytes ; immunology ; pathology ; Platelet Membrane Glycoprotein IIb ; analysis ; Purpura, Thrombocytopenic, Idiopathic ; blood ; immunology ; pathology

OBJECTIVEThrombocytopenic hemorrhage is one of the major appearance in pediatric hemorrhagic diseases, in which, idiopathic thrombocytopenic purpura (ITP) is the most common disease. Thrombocytopenia is the earliest phenomenon or the only one in certain phases of hemorrhagic diseases, such as ITP, aplastic anemia (AA) and myelodysplastic syndrome (MDS). By now, the pathogenesis of thrombocytopenia in different diseases has not been clearly determined. At present, it is very difficult to diagnose these diseases and estimate their prognosis with current clinical data. In this study, morphological characteristics and hematopoiesis function of bone marrow megakaryocyte in pediatric patients with ITP, AA and MDS were observed and the cause and mechanism of different thrombocytopenias were analyzed.

METHODSThere were 16 children with ITP, 17 with AA and 16 with MDS in this study. CD41 McAb immunohistochemical technique was used to detect micromegakaryocyte on bone marrow smears. Plasma clot culture and CD41 McAb immunohistochemical technique were used for the MK-colony forming assay. The colony formation rate of colony formation unit-megakaryocyte (CFU-MK) and burst formation unit-megakaryocyte (BFU-MK) were counted.

RESULTSThere was no statistical difference on the positive rates of micromegakaryocyte and type I lymphoid small micromegakaryocyte between groups of ITP and control. The number of micromegakaryocyte and the formation rates of CFU-MK in ITP group were significantly higher than those in control group. Among AA patients, the numbers of MK, micromegakaryocyte and the formation rates of CFU-MK, BFU-MK in vitro significantly decreased. There was no significant difference in the positive rate of micromegakaryocyte between groups of MDS and control, but the number of micromegakaryocyte and the positive rate of type I lymphoid micromegakaryocyte were significantly higher than those of control group. There was no statistical difference of the formation rate of CFU-MK between groups of MDS and control. But in 63% childhood patients, the formation rate of CFU-MK decreased, 25% increased,and 13% was normal; BFU-MK formation rate decreased significantly in MDS group.

CONCLUSIONOverproliferation of bone MKs may exist in most ITP patients. For obviating the nosogenetic factors, the normal MK releasing platelet could be easily found in the culture system. But the colony formation rate of MK decreased in a few patients with CITP. The abnormality of MK might be one of the reasons for thrombocytopenia in partial patients with ITP. Underproliferation of MKs may exist in AA, but no pathosishemogenesis was found. The dysfunction of early phase MK progenitor and stem cell might be the major reason for AA, but not the abnormality of hematopoietic microenvironment. There may be two kinds of megakaryocyte clones in bone marrow of children with MDS. One may be pathologic and potentially malignant micromegakaryocytes, the other may be the normal megakaryocytic precursors. The increase of pathologic MK resulted in abnormal development and maturation of MK in bone marrow. The change of megakaryopoiesis showed different in ITP, AA or MDS. Using bone marrow smear megakaryocyte counting, small micromegakaryocyte immunohistochemical detecting and the formation rate of bone marrow MK colony assay, the different thrombocytopenia can be diagnosed during the early stage of ITP, AA or MDS.

Adolescent ; Anemia, Aplastic ; blood ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Megakaryocytes ; pathology ; physiology ; Myelodysplastic Syndromes ; blood ; Purpura, Thrombocytopenic ; blood

Objective:To explore clinical application effect of cardiac remote real -time monitoring system.Methods:Cardiac remote real -time monitoring warning instrument(iHolter)was applied in 210 patients.The iHolter gave a-lerts automatically in case of ECG abnormalities for corresponding treatment in time,and it offered corresponding reports on monitoring results.According to age,patients were divided into youth group(<45 years,n=59),mid-dle-aged group(45160 years,n=56)and aged group(≥60 years,n=95).Characteristics of arrhythmias among different age and sex were analyzed.Results:ECG abnormalities were found in 191 cases(90.95%)out of 210 pa-tients,including eight cases with malignant arrhythmias,in which five cases were treated and survived after timely intervention via alerts.Compared with youth group and middle -aged group,there were significant rise in percenta-ges of paroxysmal atrial tachycardia(16.9%,26.8% vs.54.7%)and atrial fibrillation(0%,0% vs.8.4%)in aged group,P< 0.05 or <0.01;abnormal percentages of heart rate variability of middle -aged group and aged group were significantly higher than that of youth group(25.0%,36.8% vs.5.1%,P<0.01 both).Male percent-age of paroxysmal ventricular tachycardia was significantly higher than that of female(81.3% vs.18.8%,P=0.013).Conclusion:Cardiac remote real-time monitoring system can offer timely alerts for cardiovascular events such as arrhythmia and myocardial ischemia etc.,fight for more time for rescuing patients,maximally protect cardi-ac function and improve accuracy of clinical diagnosis.