[Objectives] To evaluate characteristics of Kawasaki disease(KD) in children younger than 5 years old in comparison with older than 5 years old, and to improve the knowledge of clinicians on KD in older children. [Method] The clinical characteristics and treatment of Kawasaki disease from January, 2004 to May,2011 were analyzed retrospectively and summarized .[Results] A total of 158 patients were included in this study, 39 patients(24.7%) were ≥5 years old and 79 patients(75.3%) were<5 years old. The older children seemed to have longer total fever duration, pre-intravenous immunoglobulin(IVIG) and post-IVIG fever duration and higher coronary artery disease(23.08% vs.8.40%) than the younger children, and the incidence rate of incomplete KD was higher in younger infant. But there was no difference in effect of IVIG ,incidence of conjunctival hyperemia, extremity hardness, cervical lymphadenopathy and rash, etc(P>0.05). There was statistical difference in erythrocyte sedimentation rate(ESR), hemoglobin(Hb) and white blood cell(WBC) count between 2 groups(P<0.05).The expression of inflammation factor in acute phase of older children was higher than the younger children(P<0.05). [Conclusions] Older patients had a higher prevalence of KD and coronary artery abnormalities than the younger patients. The occurrence of coronary artery might be related to more marked inflammatory response.

Objective To analyze the influence of Wiltse approach and conventional transmuscular approach on the mul?tifidus muscle by imageology, histology and electrophysiology assessment following short?segment pedicle fixation on thoracolum?bar fractures. Methods 76 patients with thoracolumbar fractures without neurological deficits who had undergone short?segment pedicle fixation between June 2010 and August 2012. Wiltse approach 36 cases, conventional transmuscular approach 40 cases. The perioperative parameters, Visual Analogue Scale scores (VAS), and radiologic parameters, esp the imageology, histology and electrophysiology changes of multifidus muscle were compared. Results 20 cases were fellowed up over 1 year in the Wiltse ap?proach group (20/36, 56%). 25 cases were fellowed up over 1 year in the conventional transmuscular approach group (25/40, 62.5%). No significant differences were found in terms of gender, age, fracture type, injured segment and follow?up period. Till the last follow?up, all patients with vertebral fractures were healed. No loosening or breaking of internal fixation was observed. Com?pared to the conventional transmuscular approach, the Wiltse approach was significantly advantageous in terms of operation time, the amount of bleeding, hospital stays and VAS scores after the surgery but the length of incision, besides, the Wiltse approach group had less incidence of multifidus atrophy and less fatty infiltration, and in conventional transmuscular approach group electro?myography demonstrated that the multifidus muscles median frequency values and average amplitude value were significantly low?er than Wiltse approach group. Conclusion The Wiltse approach for thoracolumbar fractures, retaining the posterior ligament complex, is an effective and minimally invasive treatment, with less trauma, less bleeding, less operation time, the advantages of re?liable clinical results. Especially less incidence of multifidus atrophy and less fatty infiltration.

Objective To develop a superparamagnetic iron oxide nanoparticles ( SPIO ) based on MRI probe specifically targeting human epidermal growth factor receptor 2 (HER2) and explore its value as MRI positive contrast agents in vitro.Methods (1) The superparamagnetic iron oxide ( PS) was obtained by means of classical coprecipitation in polylactic acid solution , then coupled with fluorescein isothiocyanate (FITC) labeled LTVSPYW to develop the targeted probe ( FITC-LTVSPWY-PS).The particle size was measured under transmission electron microscope.Relaxation rate was detected by 3.0 T MR scanner.(2) Climbing films of human breast cancer cell MCF-7 were prepared and incubated with FITC-LTVSPWY-SPIO, then fluorescence distribution was observed under inverted microscope.And distribution of iron particles was confirmed by prussian blue staining.(3) MCF-7 and MDA-MB-231 cells were incubated with FITC-LTVSPWY-SPIO and PS, respectively.MCF-7 incubated with FITC-LTVSPWY-PS were used as experimental group, MCF-7 treated with PS as control group , and cells added with nothing as blank group.There were 3 samples in each group.The MR imaging was performed only once and T 2 WI signal intensity of cells was recorded.The comparison of T 2 signal intensity among groups was conducted by using one-way ANOVA.Results The core and surface size of nanoparticles were (13.9 ±1.6) nm and (122.0 ±5.5) nm respectively.Zeta potential and relaxation rate of the FITC-LTVSPWY-PS were ( -30.7 ±2.2 ) mV and 70.7 m· M-1 · s-1 respectively, and the PS were (28.1 ±2.8) mV and 72.1 m· M-1 · s-1 respectively.The fluorescence could be seen on the surface of MCF-7 cells, and the prussian blue staining showed that FITC-LTVSPWY-PS could specifically target HER 2-positive cells.The low signal on T 2 WI was observed in MCF-7 cells incubated with FITC-LTVSPWY-PS, whereas cells treated with PS and blank group showed equal signals , the T2 values were ( 61.8 ±5.7 ) , ( 101.6 ±2.5 ) and ( 103.5 ±1.9 ) ms respectively.Significant difference existed among these groups ( F =355.698, P <0.05 ).Conclusions The MR targeting probe FITC-LTVSPWY-PS was prepared successfully , its physical characterization and magnetic properties could target the HER 2 highly expressing on the surface of breast cancer cells and meet the need of targeted imaging.It provides an important tool for MR molecular imaging.

OBJECTIVE:To investigate the effects of Kouyanqing granules on prevention and treatment of radiation-induced oral mucositis patients with head and neck cancer after radiotherapy.METHODS:A total of 122 head and neck cancer patients receiving radiotherapy were randomly divided into kouyanqing group (61 cases) and chlorhexidine group (61 cases).Based on radiotherapy,kouyanqing group was given Kouyanqing granules 20 g dissolved in 50 mL lukewarm boiled water,twice a day,2-3 d before radiotherapy.Chlorhexidine group was given Compound chlorhexidine gargle 10-20 mL,twice a day,2-3 d before radiotherapy.Treatment courses of 2 groups lasted for 7 weeks.The occurrence of oral mucositis,VAS scores and ADR were observed in 2 groups.RESULTS:3rd week radiotherapy later,the incidence of oral mucositis at level 2-3 and 4th-7th week radiotherapy later,the incidence of oral mucositis at level 2-4 in kouyanqing group was significantly lower than chlorhexidine group,with statistical significance (P＜0.01).2nd-7th week radiotherapy later,VAS score of kouyanqing group was significantly lower than that of chlorhexidine group,with statistical significance (P＜0.01).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Kouyanqing granules can relieve radiation-induced oral mucositis of head and neck cancer and the degree of pain,and improve the quality of life.Its safety is similar to that of chlorhexidine.

BACKGROUND: Although ABO-incompatible (ABOi) kidney transplantation (KT) has been performed successfully, a standard preconditioning regimen has not been established. Based on the initial antidonor ABO antibody titers, an individualized preconditioning regimen is developed, and this study explored the efficacy and safety of the regimen. METHODS: From September 1, 2014, to September 1, 2020, we performed 1668 consecutive living-donor KTs, including 100 ABOi and 1568 ABO-compatible (ABOc) KTs. ABOi KT recipients (KTRs) with a lower antibody titer (≤1:8) were administered oral immunosuppressive drugs (OIs) before KT, while patients with a medium titer (1:16) received OIs plus antibody-removal therapy (plasma exchange/double-filtration plasmapheresis), patients with a higher titer (≥1:32) were in addition received rituximab (Rit). Competing risk analyses were conducted to estimate the cumulative incidence of infection, acute rejection (AR), graft loss, and patient death. RESULTS: After propensity score analyses, 100 ABOi KTRs and 200 matched ABOc KTRs were selected. There were no significant differences in graft and patient survival between the ABOi and ABOc groups (P  = 0.787, P  = 0.386, respectively). After using the individualized preconditioning regimen, ABOi KTRs showed a similar cumulative incidence of AR (10.0% υs . 10.5%, P  = 0.346). Among the ABOi KTRs, the Rit-free group had a similar cumulative incidence of AR ( P  = 0.714) compared to that of the Rit-treated group. Multivariate competing risk analyses revealed that a Rit-free regimen reduced the risk of infection (HR: 0.31; 95% CI: 0.12-0.78, P  = 0.013). Notably, antibody titer rebound was more common in ABOi KTRs receiving a Rit-free preconditioning regimen ( P  = 0.013) than those receiving Rit. ABOi KTRs with antibody titer rebound had a 2.72-fold risk of AR (HR: 2.72, 95% CI: 1.01-7.31, P  = 0.048). ABOi KTRs had similar serum creatinine and estimated glomerular filtration rate compared to those of ABOc KTRs after the first year. CONCLUSIONS An individualized preconditioning regimen can achieve comparable graft and patient survival rates in ABOi KT with ABOc KT. Rit-free preconditioning effectively prevented AR without increasing the risk of infectious events in those with lower initial titers; however, antibody titer rebound should be monitored.
Humans ; Kidney Transplantation/adverse effects* ; Living Donors ; Kidney ; Immunosuppressive Agents/therapeutic use* ; Rituximab/therapeutic use* ; ABO Blood-Group System ; Graft Rejection ; Graft Survival