Humans ; Sialorrhea ; etiology ; therapy

Objective To investigate the genetic variation and molecular evolution of human bo-cavirus 1 (HBoV1) strains isolated during 2009 to 2014 in Hangzhou, China.Methods Throat swab sam-ples were collected from children with acute respiratory tract infections in the Children′s Hospital Affiliated to the Zhejiang University School of Medicine from 2009 to 2014.Real-time PCR was performed for the detec-tion of HBoV1 strains.Fifteen HBoV1 strains with high virus load were screened out for the amplification and sequencing of complete genomes.The complete genomes were submitted to GenBank for further analysis with bioinformatics software.Results A total of 48 nucleotide mutations were detected in the complete genomes of 15 HBoV1 strains, resulting in 11 amino acid mutations with 5 of them located in the active region of phospholipase A2 ( PLA2) .The 15 HBoV1 isolates along with 16 HBoV1 strains in GenBank were classified into three clusters as indicated by the phylogenetic analysis based on their complete coding sequences.All of the 15 strains were belonged to clusterⅠ, the representative strain of which was the Sweden prototype strain ST2.The phylogenetic trees constructed using genes encoding the capsid proteins VP1 and VP2 were highly similar to those based on the complete coding sequences.The estimated mean evolutionary rate of HBoV1 with regard to the complete coding sequence was 3.03×10-4(95%HPD, 2.14×10-4-3.92×10-4 ) substitu-tions per site per year.With regard to each gene, the NS1 gene was considered to the most conserved gene while the NP1 gene showed the highest substitution rate.The dN/dS ratios (ω) of the four genes were all less than 1, indicating that all of them were under negative selection.Moreover, the VP2 gene was under the strongest negative selection, while the NP1 gene was under the weakest negative selection.Conclusion All of the HBoV1 isolates circulating in Hangzhou province during 2009 to 2014 were belonged to ST2 genotype with a relatively high mutation in the area of PLA2.Despite the complete genome was conservative, its evo-lutionary rate was high.Among the four genes, the NP1 gene showed the highest substitution rate.All of the four genes were under negative selection, of which the VP2 gene was under the strongest negative selection.

Objective To detect adenovirus from children with acute upper/lower respiratory tract infections and to investigate the genetic evolution of virus .Methods A total of 1 178 clinical specimens were collected from the Children ’ s Hospital , Zhejiang University School of Medicine during March 2011 and February 2013, including 513 throat swabs from children with acute upper respiratory tract infection and 665 nasopharyngeal aspirates from children with acute lower respiratory tract infections .Besides, 9 specimens in an outbreak of adenovirus infection during 2011 and 2014 were also collected .Adenovirus was identified by real-time fluorescent polymerase chain reaction (RT-qPCR).The hypervariable region (HVR)-7 region of hexon gene in positive samples was amplified and sequenced for typing and phylogenetic analysis .Other respiratory viruses were also detected with RT-qPCR in adenovirus positive samples .Clinical characteristics of adenovirus infection were analyzed in children with lower respiratory tract infections .Chi-square test and Fisher exact probability were used for data analysis .Results Among 1 178 samples from sporadic cases , 104 samples (8.83%) were adenovirus positive .The rates of adenovirus infection in upper respiratory tract infection group and lower respiratory tract infection group were 13.65%(70/513) and 5.11%(34/665), respectively (χ2 =26.193, P<0.05).Compared with that in lower respiratory tract infections , positive rates of adenovirus were higher in upper respiratory tract infections in children aged 0-1 year and >3 years (χ2 =6.575 and 7.334, P<0.05 or <0.01).Adenovirus infection might occur throughout the year and peaked in spring and summer .Among 54 adenovirus-positive samples from 104 sporadic cases , adenovirus types 1, 2, 3, 4, 7 and 31 were identified in 4, 6, 26, 2, 15 cases and 1 case, respectively.While among 9 adenovirus-positive samples from outbreak cases , type 4 and type 3 were identified in 1 and 8 cases, respectively .The HVR-7 region of hexon gene was highly homologous in the same type , and the sequence alignment indicated that the sequence of HVR-7 might have regional differences .Nine out of 70 children (12.86%) were co-infected with other virus in upper respiratory tract infection group , while the rate of co-infection in lower respiratory tract infection group was much higher [58.82%(20/34), χ2 =24.045, P<0.05 ].There was no significant difference in clinical manifestations between children infected with adenovirus only and those with co-infection in lower respiratory tract infection group (P>0.05), but two children with co-infection died.Conclusions Adenovirus infection is more common in upper respiratory tract infection .Adenovirus type 3 and type 7 are the most prevalent serotypes in sporadic cases , while type 3 is the most prevalent serotype in outbreak cases .

Professional postgraduates in geriatric medicine are one of the most important re-courses of geriatric specialists. However, training model for geriatric postgraduates is still unclear in China. In general, geriatric medicine has no independent training plan, and is included in internal medicine training. Such model cannot represent the feature of geriatric medicine. The present paper aimed to discuss the ability construction for geriatric postgraduates based on the geriatric medicine specialist training experience both at home and abroad, including diagnosis and treatment of multi-system diseases, ability of geriatric assessment, management of geriatric syndromes, consultation for geriatric rehabilitation and ability for continuity health service in order to cultivate the compound tal-ents suitable for the aging society requirement for geriatric medicine in China.

Objective To discuss the clinical effect of transurethral cystitis glandularis electrocision combined with treating the diseases under bladder outlet in female.Methods One hundred and two female cases of cystitis glandularis who received transurethral electrical resection of the bladder mucosa combined with treating the diseases under bladder outlet were selected as experimental group,and another 78 female cases were selected as control group,who only received transurethral electrical resection of the bladder mucosa.The visual analogue score (VAS) was observed before and after a 12-week treatment,and the efficacy was evaluated by analysis of non parameter RIDIT.Results The operation time in experimental group and control group were 15-40 (26 ± 13) min and 8-19 (13 ± 5) min,respectively,and there was significant difference between two groups (P ＜ 0.05).Two groups cases urinated smoothly after the removal of catheter,without the occurrences of urinary fistula and incontinence.During the 12-weeks of follow-up,44 cases were cured,31 cases improved,15 cases were effective and 12 cases unimproved in experimental group; 26 cases were cured,21 cases improved,16 cases were effective and 15 cases unimproved in control group.There was significant difference between two groups (R =0.576,95％ CI0.519-0.633,P＜ 0.05).Conclusion Although the operation time is lengthened by transurethral cystitis glandularis electrocision combined with treating the diseases under bladder outlet in female,this method obviously improves curative effect.

Objective To study the different expression of microRNA(miRNA) including mir-29c,mir-200a,mir-145 in the mid-secretary endometrium and its relationship with infertility of endometriosis.Methods From August 2011 to February 2013,36 infertile cases with endometriosis confirmed by laparoscopy and pathology and excluded the other infertile factors in Department of Reproductive Medicine in Peking University Shenzhen Hospital were enrolled in this study,which were divided into 17 cases with stage Ⅰ-Ⅱ,19 cases with stage Ⅲ]-Ⅳ according to the revised classification American Fertility Society.Forty-four healthy women with male factor infertility were chosen as control group.The relative expression levels of mir-29c,mir-200a,mir-145 in the endometrium of women in two groups were detected by using real-time quantitative polymerase chain reaction.Those women were followed up for pregnancy outcome of endometriosis group after assisted reproductive techniques (pregnancy and nonpregnancy group respectively).Results (1) The expression of miRNA between endometriosis and control groups:the average expression level of mir-29c,mir-200a,mir-145 in the endometrium of endometriosis group was 2.46 ± 1.98,3.20 ± 2.45,6.378 ± 3.275,which were significantly higher than 1.36 ± 1.05,2.04 ±1.16,4.548 ± 1.885 in control group (P =0.026,0.027,0.041,respectively).(2) The expression of miRNA between Ⅰ-Ⅱ stage and Ⅲ-Ⅳ:the average expression level of mir-29c,mir-200a,mir-145 in the endometrium was 0.53 ± 0.51,0.33 ± 0.26,0.048 ± 0.021 in patients with of stage Ⅰ-Ⅱ,while 0.26 ±0.18,0.28 ±0.12,0.045 ±0.016 in stage Ⅲ-Ⅳ respectively,there were no statistically significant differences between the two groups(P =0.191,0.661,0.753,respectively).(3) The expression of miRNA between pregnancy and non-pregnancy groups:the average expression level of mir-29c,mir-200a,mir-145 in the endometrium were 0.60 ± 0.30,1.23 ± 0.48,0.886 ± 0.238 in pregnancy group,while 2.64 ± 1.73,4.39 ± 2.58,7.199 ± 3.945 in non pregnancy group,there were statistically significant differences between the two groups(P =0.030,0.039,0.028,respectively).Conclusion Up-regulation of mir-29c,mir-200a,mir-145 in the endometrial tissue might play a role in endometriosis associated infertility.

Objective To evaluate the efficiency of interventional treatment for primary liver cancer with spontaneous rupture. Methods Three cases of spontaneous rupture of primary liver cancer were undertaken hepatic arterial chemoembolization with prior chemo-infusion and followed by gelfoam partical and stripes for embolization Results 3 cases of massive type of primary liver carcinoma with spontaneous rupture were all successfully once embolized, including one with additional super liquefied lipiodal as embolic agent who has been survived for more than 20 months. Conclusions Hepatic arterial chemo-embolization shows prominent hemostasis during emergency for spontaneous rupture of primary hepatic carcinoma providing double effectiveness of hemostasis and treatment.

ObjectiveTo investigate the clinical features and pregnant outcomes of the pregnant women with congenital adrenal hyperplasia (CAH) 21-hydroxylase deficiency (21-OHD).MethodsThe clinical features,therapies,pregnant outcomes of the pregnant women with 21-OHD were retrospectively reviewed in Peking Union Medical College Hospital,from January 2005 to April 2011.ResultsThere were 8 pregnant womenwith 21-OHD including 5siinplevirilizing patientsand 3nonclassical 21-OHD women.Eightpatientswereacceptedprogestationalandprenatalcontinuallowerglucocorticoid treatment.During the gestational period,the dosage of glucocorticoid was adjusted in one pregnancy.The serum level of 17-alpha hydroxyprogesterone (17-OHP) were elevated after pregnancy [ (70 ± 38 ) versus (24 ±23) nmol/L,P ＜ 0.05].The fertility and offspring rate of 8 patients was 8/12,the fertility and offspring rate of patients who started treatment at preadolescence was significantly increased (4/5 versus 4/7).Four patients were accepted genital reconstructive surgery ( clitorectomy,clitoroplasty,vulvoplasty) before pregnancy.The incidence of GDM was 1/8.All patients selected caesarean at from 37 +6 gestation weeks to 39+6 gestation weeks.The average newborn birth weight was (3210 ± 447 ) g,and height was (48 ±2) cm of 8 neonates,none of them was CAH.Conclusions Medical and surgical therapy provides satisfactory fertility and pregnancy outcomes for women with 21-OHD.It is safe to pregnant women with 21-OHD and their fetus in continual lower glucocorticoid treatment.The dosage of glucocorticoid should be carefully adjusted during the pregnancy individually according to serum level of 17-OHP.

Objective To evaluate the effect of preloading the epidural space with normal saline (NS) on the incidence of injury to blood vessel by epidural catheter placement for cesarean section. Methods One hundred and fifty parturients with a single baby at full term in vertex presentation scheduled for cesarean section under continuous epidural anesthesia were randomly divided into 3 groups ( n = 50 each): Ⅰ group control; Ⅱ group NS needle attached to a 5 ml syringe. Loss of resistance was used to identify the epidural space. In group Ⅰ no fluid was injected into the epidural space before insertion of catheter; while in group Ⅱ and Ⅲ NS 5 ml with or without whom blood or blood tinted fluid was withdrawn from epidural catheter was recorded. Results The number of patients in whom blood or blood tinted fluid was withdrawn from epidural catheter was significantly lower in group Ⅱand Ⅲ than in group Ⅰ but was not significantly different between group Ⅱ and Ⅲ. Conclusion Preloading the epidural space with 5 ml NS can reduce the incidence of injury to blood vessel induced by insertion of epidural

Adult ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Radiation, Ionizing ; Radiology Department, Hospital ; Serum ; metabolism ; radiation effects ; Testosterone ; blood ; Thyroid Hormones ; blood