Objective To study the correlation between single nucleotide polymorphisms of -238,-308 G/A in promoter region of tumor necrosis factor -?(TNF-?) gene and the type of juvenile idiopathic arthritis (JIA).Methods Clinical data and blood preparation of 127 children with JIA and 106 healthy children were evaluated.Subgroups of JIA were defined according to the Edmonton criteria.The -238 G/A and -308 G/A polymorphisms in DNA analysis in this study were extracted from the whole blood.The restricted fragment length polymorphisms were determined in the cases of all JIA children and control group.Results 1.The TNF-?-238 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 92.9% and 7.1%,and the control group was 95.3% and 4.7%.The distribution of allele frequencies was no significantly different between JIA group and control group(?2=1.149 P=0.284).But there were significant difference between polyarticular JIA (RF negative) and control group(?2=7.621 P=0.006).2.The TNF-?-308 G/A allele frequencies of JIA group and control group:allele frequency of JIA group was 94.1% and 5.9%,the control group was 95.3% and 4.7%.The distributions of allele frequencies was no significantly different between JIA group and control group(?2=0.322 P=0.571).There were significantly difference between polyarticular JIA (RF negative) and control group (?2=7.621 P=0.006).Conclusions The TNF-?-238,-308 polymorphisms of A in the-238 and-308 TNF-? gene are important to the joint destruction of JIA.The study will be beneficial to provide indirect support to the application of anti-TNF drugs to the treatment of JIA.

Objective To determine whether homocysteine(Hcy)and monosodium glutamate (MSG)could lead to animal model of hypertensive disorder complicating pregnancy and its mechanism. Methods Female adult Wistar rats were randomly divided into 4 groups:pregnant control group(PN), pregnant Hcy group(PH),pregnant glutamic acid group(PG)and pregnant Hcy and glutamie acid group (PHG).The rats of each group were injected with Hey 200 mg/kg or physiological saline every day intraperitoneally and with MSG or 0.9% saline every other day via Hcy injection from the 10th day to the 20th day of pregnancy.The blood pressure,urine protein,function of liver and kidney,weight of placenta, length and weight of fetus were all measured.The histological change of the pallium and the change of behavior of pregnant rats were also observed.Results(1)The blood pressure in PH[(107?8)mm Hg, 1 mm Hg=0.133 kPa],and PHG group [(109?10)mm Hg] after the treatment increased significantly compared with those in other groups from the 12 th day after pregnancy(P

BACKGROUNDTo study the clinical features and more reasonable typing criteria for patients with chronic severe hepatitis and decompensated liver function.

METHODSData of 106 cases of decompensated cirrhosis, 124 cases of chronic liver failure and 100 cases of chronic liver failure (chronic liver failure group I, CLF I) with decompensated cirrhosis (chronic liver failure group II, CLF II) were analyzed retrospectively.

RESULTS(1) The ages were youngest in chronic liver failure group I (about 30 years), and the oldest in decompensated cirrhosis group (about 50 years). (2) There were significant differences in albumin, globulin, ALT, AST, protruding activity, blood glucose, blood lipid and cholinesterase among the three groups. (3) There was no significant difference in upper digestive tract bleeding and hepatorenal syndrome, on the other hand, there was significant difference in ascites and hepatic encephalopathy. (4) The prognosis of the patients in decompensated cirrhosis group was better than that of chronic liver failure group I and chronic liver failure group II.

CONCLUSIONThe clinical feature and prognosis in three groups were different, so, it is suggested that chronic severe liver disease be divided into 2 types: one is chronic severe liver disease type I, which is associated with chronic hepatitis, and the other is chronic severe liver disease type II, which is associated with cirrhosis, and the typing criteria for decompensated cirrhosis remains unchanged.

Adult ; Diagnosis, Differential ; Female ; Hepatitis, Chronic ; classification ; complications ; diagnosis ; Humans ; Liver Cirrhosis ; classification ; complications ; diagnosis ; Liver Failure ; etiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate the diagnosis, surgical procedure and clinical outcome of cervical intraspinal benign neoplasm.

METHODSTwenty-two cases confirmed pathologically were reviewed included 16 males and 6 females with an average age of 43.8 years old ranging from 18 to 56 years. Symptoms mainly included neck pain, numbness and weakness of the extremities, urinary and fecal incontinence, pyramid signs, etc. All underwent X-ray, CT and MRI, 11 cases were diagnosed as neurilemomas, 4 neurofibromas, 3 spinal meningiomas, 2 intraspinal cysts and 2 lipomas. The tumors were removed completely in 18 cases, above 60% in 3 cases and 25% with biopsy in 1 case. Cervical stability in 11 cases was restored after removal of tumors.

RESULTSAll were followed-up for from 6 to 84 months(means 12.5 months). Symptoms improved in 20 cases and stable in 1 case and worsened in 1 case postoperatively according to JOA scoring system. Two patients recurred and were treated with second surgery. JOA scoring was (6.52 +/- 1.10) before operation, (11.42 +/- 0.79) after operation, there was statically significance (t = 21.38, P < 0.001). The average recover ratio of total was (46.7 +/- 2.46)%, cervical stability was (62.37 +/- 3.58)%, the other methods was (41.21 +/- 4.63)%. The results of JOA were excellent in 18 cases, good in 2, fair in 1 and poor in 1.

CONCLUSIONThe surgical exairesis for cervical intraspinal benign neoplasm has low post-operative recurrence. The main reason of recurrence is not removed the tumor completely. MRI is regarded the effective method which is helpful in differential diagnosis and surgery guidance.

Adolescent ; Adult ; Cervical Vertebrae ; pathology ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Spinal Neoplasms ; pathology ; physiopathology ; surgery ; therapy ; Treatment Outcome ; Young Adult

Abstract: Objective　To explore the spatial epidemiological characteristics of severe cases hand, foot and mouth disease (HFMD) in Guangxi, China, from 2014 to 2018, and to provide a basis for identifying the high-risk regions as well as the prevention and control of severe cases of HFMD in Guangxi. Methods　Spatial-temporal scanning analysis, global and local spatial autocorrelation analysis were used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD. Results　From 2014 to 2018, the incidence and severe case fatality rates of HFMD were 3.89/100 000 and 4.23%, respectively. Monte Carlo scanning analysis showed that the first cluster region was Cenxi City, the second cluster was mainly concentrated in northwest of Guangxi, and the aggregation time was mainly concentrated in April to May and August to October. The global spatial autocorrelation analysis showed that the severe HFMD was significant clustering distribution, and the Moran's I coefficients of the sever cases, severe morbidity and severe case fatality rate were 0.088, 0.118, 0.197, respectively (P<0.05). Local spatial autocorrelation analysis showed that hotspots of severe HFMD cases were concentrated in the southern Guangxi, mainly in Lingshan County. Anselin local Moran's I clustering and outlier analysis indicated that 5 high-high (H-H) clustering regions for fatality were Lingshan, Pubei, Zhongshan, Zhaoping and Pinggui County. There were 6 high-high (H-H) clustering regions for severe incidence rate, namely Lingshan, Qinnan, Lingyun, Youjiang, Bama Yao Autonomous and Pinggui County, and 1 high-low (H-L) clustering region, Cenxi County. The trend surface analysis showed that the overall number of severe cases of death decreased from east or west to the middle, and increased from north to middle, and then decreased to south. Conclusions　Severe HFMD cases in Guangxi have obvious spatial-temporal clustering, and the hop spots are mainly concentrated in southern Guangxi. The prevention and control of HFMD in areas with high incidence of severe cases should be strengthened to reduce the burden of HFMD cases.

Objective To investigate the clinical effect of improved nursing intervention in blood glucose control of critical patients. Methods By means of historical control, 258 critical patients undergone intense insulin therapy were divided into the control group (n = 126) and the test group (n = 132). The control group was given conventional intensive insulin therapy. The test group was given improved guidelines on the use of insulin and improved nursing intervention. The following indexes of the two groups were documented and compared: the time required to achieve target blood glucose level [(11.95 ± 1.97) h vs (18.85 ± 3.59) h, t =19. 237 3 ,P ＜0. 01]; frequency of blood glucose measuring in four days, the range of everyday blood glucose and the occurrence of hypoglycemia during therapy. Results The test group had shorter time required to achieve target blood glucose level, lower frequency of blood glucose measuring, less fluctuation range of blood glucose and reduced occurrence of hypoglycemia during therapy than the control group (P ＜ 0. 01). Conclusions The use of improved guidelines on the use of insulin and improved nursing intervention in intensive insulin therapy of critical patients can effectively control blood glucose, reduce frequency of hypoglycemia and improve prognosis.

Objective To explore the reason and remedy on tumor patients' PICC misplacement.Methods The reason of 32 tumor patients' PICC misplacement were analyzed. The patients whose PICC misplaced were observed by X-ray,and then regulated to precava before remove the wire.Results PICC misplacement was much more observed in patients who was sixty years old or above than that of their younger counterpart (x2 =4.733,P ＜0.05).87.5％ of PICC misplacement were observed in the ipsilateral vein and less observed in right upper extremity ( x2 =7.552,P =0.006).The rate of PICC misplacement of cephalic vein,median cubital vein and basilic vein respectively were 15.7％,8.89％ and 8.12％.And there was no significant difference was detected in the gender,method and the location of cancer ( P ＞ 0.05 ).Finally,all the misplacement PICC were regulated to the right place.Conclusions Adept technology makes success,and more attention should pay to elderly patients.It is better to insert PICC in patient' s right upper extremity,especially basilic vein,and then median cubital vein.Utilize the X-ray to adjust patients position,and matching inspiration to adjust PICC' s location in order to avoid misplacement.

Objective To investigate the brain mechanisms of aging of the visual attention. Methods Through the precue-target visual search paradigm using the event-related potentials technique,16 young and 16 elderly subjects participated the electrophysiological experiment.The background was comprised of three homocentric black circles and eight English capital letters consisted of each circle.The letter “T” was designed as the target stimulus.T was a target only when it located the circle clued to the same size of the precue.For example,when the cue was the “large”,“T” may appear within 3 circles.When the cue was the “median”,“T” may appear within either the median or small circles.When the cue was small,the target “T” may appear only within the small circle. Results The reaction time of the two groups of subjects became quick with the reduction of the cue scale,while the amplitudes of P1 and N1 components of event-related potentials increased with the decrease of the cue scale.Old subjects showed longer response time than did young subjects,and the posterior P1 component was enhanced significantly and N1 component was inhibited obviously.The P2 component was manifested as significantly inhibitory effect not only in the amplitude but also in the abnormal and unstable waveform.Conclusions The cognitive function of elderly subjects declines in the research of target stimuli,which suggests that the age-related changes could lead to deficit in the posterior area of the brain to visual spatial attention (involuntary attention).

OBJECTIVEThis paper presents the experience in using the reverse buccinator musculomucosal flap for repairing the defect following excising inverted papilloma of the nose.

METHODSAfter the inverted papilloma of the nose was excised through an endonasal approach, the reverse buccinator musculomucosal flap supplied by the retrograde blood flow of the anterior buccal artery was harvested and sutured to the defect through the ora-nasal tunnel. The procedure was performed on three patients.

RESULTSThe postoperative course was uneventful. All the flaps survived completely.

CONCLUSIONSThe technique provides the solution to prevent nasal stricture from cicatricial contracture after excising inverted papilloma. In the operation, excising the inverted papilloma and repairing the defect was performed simultaneously, saving another operation for the secondary deformity. The technique is also applicable to the treatment of existing cicatricial stricture of the nose.

Humans ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Nose Neoplasms ; pathology ; surgery ; Papilloma, Inverted ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVETo detect CCL20 and CXCR4 expressions in epidermis infected with condyloma acuminatum (CA) and normal epidermis and investigate the effect of their expressions on Langerhans cells in CA epidermis.

METHODSGene expression of CCL20 and CXCR4 in 3 epidermal CA lesions and in 3 normal epidermis specimens were detected using Affymetrix oligonucleotide microarrays HG-U 133A 2.0, and the protein levels of CCL20 and CXCR4 in these specimens were measured by Western blotting.

RESULTSMicroarray analysis revealed markedly down-regulated mRNA expressions of CCL20 and CXCR4 in the 3 epidermal CA lesions as compared with those in the normal specimens. Western blot analysis showed that the protein expressions of CCL20 and CXCR4 in the CA lesions were significantly lower than those in normal epidermis.

CONCLUSIONThe protein and mRNA expressions of CCL20 and CXCR4 are markedly down-regulated in epidermal CA lesions, which may contribute to decreased number and backflow disturbance of Langerhans cells in these lesions.

Adult ; Blotting, Western ; Chemokine CCL20 ; genetics ; metabolism ; Condylomata Acuminata ; genetics ; metabolism ; Down-Regulation ; Epidermis ; metabolism ; pathology ; Gene Expression Regulation ; Humans ; Oligonucleotide Array Sequence Analysis ; RNA, Messenger ; genetics ; metabolism ; Receptors, CXCR4 ; genetics ; metabolism ; Young Adult