Child ; China ; Congresses as Topic ; Humans ; Syncope ; diagnosis ; therapy ; Tilt-Table Test

Objective To analyze the appropriate time selection of pregnancy and delivery in women with systemic lupus erythematosus (SLE ). Methods Twenty-nine pregnancies in women with SLE in our hospital from 1998 to 2003 were retrospectively analyzed regarding the selection of appropriate time of pregnancy and delivery. Results All patients did not take any cytotoxic medicine for at least 6 months before pregnancy. Twenty-three conceptions occurred when SLE was inactive for at least 1 year. Two conceptions occurred when SLE was active without doctors' agreement SLE was diagnosed during pregnancy in the remaining 4 cases. The condition of all patients fluctuated and the gestational time at delivery ranged from 30 to 38 weeks after we modified the doses of glucocorticoid (prednisone). Among totally 29 living neonates, eight were premature neonates, three were FGR and one had serious congenital heart disease. Two neonates died of complications in early stage of neonatal period. None of the 29 neonates from all patients had neonatal lupus. Conclusion Pregnancy safety will be improved obviously if the condition of SLE is controlled and the patients are given reasonable doses of glucocorticoid and intensive monitoring. If pharmacotherapy does not work well and the condition threatens the safety of mother and fetus, or the fetus has matured, termination of pregnancy should be done on time, which reduces maternal complications and improves the perinatal mortality rate. The gestational time should be 34 to 38 weeks.

OBJECTIVE: To study the effect of hypertonic seawater and isotonic seawater for nasal mucosa of allergic rhinitis mice model, and explore the possible mechanism of nasal irrigation with seawater in treatment of allergic rhinitis. METHOD: We used Der pl to make allergic rhinitis model of BALB/c mice, and divided them into three groups randomly. Nasal irrigation with hypertonic seawater (HS) or isotonic seawater (IS) in the treatment group 1-14 days after modeling, and black control (BC) group was given no treatment after modeling. Normal control (NC) group was given no treatment, the number of rubs and sneezings in each group were counted in 30 min after the last nasal irrigation. Mice were then killed 24 h after the last therapy. The noses of mice from each group were removed and fixed, then the slices were stained with hematoxylin and eosin, the others were observed by transmission electron microscope. RESULT: Mice with hypertonic seawater and isotonic seawater were significantly improved in rubs and sneezings compared to the black control group (P<0. 05); The number of eosinophiles in mucosal tissues of HS group and IS group had no significant difference with that of the black control group (P> 0. 05); Ciliated columnar epithelium cells in mucosal tissues of HS group and IS group were arranged trimly, better than that in the black control group. Morphology and microstructure in nasal mucosal of HS group was closer to the normal group than in IS group. CONCLUSION The injury of nasal mucosa ciliated epithelium was significantly improved by nasal irrigation with hypertonic seawater and isotonic seawater, and the former is better than the latter, the mechanism of nasal irrigation with seawater in treatment of allergic rhinitis may rely on repairing the injured nasal mucosa ciliated epithelium, thereby the symptoms of nasal was reduced.
Animals ; Disease Models, Animal ; Mice ; Mice, Inbred BALB C ; Nasal Lavage ; Nasal Mucosa ; Nose ; Rhinitis, Allergic ; therapy ; Seawater

Objective To study the feature of neonatal infections and characteristics of antibiotic treatment in a tertiary children ' s hospital. Methods Clinical data including incidence of infection, primary disease,species of bacteria, complication and antibiotic utilization in hospitalized patients from Jan. 2010 to Dec. 2012 were retrospectively reviewed using their medical records. Results Among 1826 patients admitted to neonetal surgery ward, 542 infants ( 29. 7％) were with infection. The incidence of antibiotic resistance was 23. 51％. The top five infectious diseases were:perianal abscess, necrotizing enterocolitis, colicitis, omphalitis and subcutaneous gangrene. 12 cases of multi-resistant infection were cured by non-restricted antibiotics. 109 were cured by restricted antibiotics. And other 7 were cured by special antibiotics. No death nor multi-resistant nosocomial infection were found. Risk factors including multi-site infection, premature or low birth weight infants, liver, kidney or heart dysfunction,fever lasting more than 3 days after antibiotic therapy, septic shock, sepsis, digestive tract perforation and peritonitis,were vital in choosing specific antibiotics. Conclusions Infection is one of the most common diseases in neonatal surgery ward, with major pathogens sensitive to antibiotics. The clinical characteristics and drug sensitive test are conductive to the reasonable use of antibiotics. Special antibiotics can be used directly in patients with risk factors Clinical doses of antibiotics in neonates depend on the monitoring of drug concentration.

Objective To census the preoperative prevalence rate of deep venous thrombosis (DVT) and to evaluate the risk factors of DVT in senile osteoporotic hip fractured patients.Methods The object of study were patients aged 60 and above, and osteoporotic hip fracture by low energy injury in 2013.Based on medical records, all the patients with osteoporotic hip fracture were evaluated the signs and symptoms of DVT in 24 h, D-dimer test and underwent Doppler ultrasound screening of bilateral venous system in lower extremity after admission, and all the patients received preoperative prophylactic anticoagulation.Patients with popliteal and proximal level thrombus or floating thrombus underwent inferior vena cava (IVC) filter insertion.Outcome measures: age, gender, fracture type, D-dimer value in 24 h preoperatively, occurrence time of DVT and region, grade of preoperative American Society of Anesthesiologists, preoperative medical diseases.Results 702 of 946 hip fracture inpatients were comprised in this retrospective study.All were not founded any symptom or signs of DVT.All patients were took preoperative Doppler ultrasound screening and the results as follows: 36 of 302 patients (11.9％) with femoral neck fracture were proved preoperative thrombosis(13 male, 23 female), the average age was 72.7 year-old(range from 62-90 year-old), on the same side as the fractured hip in 31 patients, bilateral thrombosis in 5 patients.74 of 400 patients (18.5％) with intertrochanteric fracture were proved preoperative thrombosis(38 male, 36 female), the average age was 76 year-old (range from 60-95 year-old), on the same side as the fractured hip in 68 patients, bilateral thrombosis in 6 patients.The most prevalence rate of DVT were in the first day after osteoporotic hip fracture, 15 patients (41.7％) with femoral neck fracture and 38 patients (51.40％) with intertrochanteric fracture.There were more proximal level and multiple level involment thrombosis over 5 days after injury.The most thrombosis were proven at calf and popliteal vein.Conclusion The prophylaxis of DVT should be started even in the emergency department in senile patient with osteoporotic hip fracture.To avoid the risk factors, early surgery and early postoperative mobilization will be effective.

We describe two cases in which a forceps imprintdeveloped in the AcrySof ReSTOR IOL optic whileinserting these IOLs into the cartridge with straightclamping forceps. In case 1 ,the AcrySof ReSTOR IOL wasexplanted and observed under scanning electronmicroscopy (SEM). The SEM showed that the stepdesign of ReSTOR Multifocal IOL was well maintained. Incase 2, visual acuity, contrast sensitivity and wavefrontmeasurements were performed and no specific changeswere found. Strong evidence does not exist that suggeststhe on-axis forceps imprint can significantly compromisevisual acuity.

The nuclear transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) plays a crucial role in maintaining cellular redox homeostasis. The aberrant NRF2 signaling confers enhanced antioxidant capacity, which is linked to tumor progression and therapeutic resistance. The current study investigates the biological effects and molecular mechanism of tribbles homolog 3 (TRIB3), a stress-induced protein, in regulating cell survival and apoptosis in lung cancer. This study first performed the RNA sequencing data analysis with 576 lung adenocarcinoma patients from the cancer genome atlas (TCGA) database. The NRF2- antioxidant response element (ARE) signature was enriched in patients with high TRIB3 expression. Dual-luciferase reporter assay and real-time quantitative polymerase chain reaction (PCR) were used to confirm the effect of TRIB3 on the kelch-like ECH-associated protein-1 (KEAP1)-NRF2 pathway. Abrogation of TRIB3 impaired NRF2 transcriptional activity and reduced the expression of its target genes. Moreover, TRIB3 enhanced NRF2 stability via blocking KEAP1-NRF2 interaction. TRIB3-depletion promoted reactive oxygen species (ROS) production, restrained cell proliferation, and enhanced carboplatin-induced apoptosis. In addition, NRF2 overexpression recovered the tumor inhibition effect of TRIB3-depletion. Consistently, TRIB3 failed to modulate apoptosis in NRF2 depletion cells. In summary, this study shows that TRIB3 inhibits the KEAP1-NRF2 interaction and upregulates the transcriptional activity of NRF2, thereby promoting lung cancer cell proliferation and reducing the sensitivity to chemotherapy. Targeting the TRIB3-NRF2 signal axis may become a new strategy for ROS homeostasis and lung cancer treatment.

Objective To evaluate the melancholia incidence in the convalescence period of cerebral hemorrhage and its correlated factors.Methods Ninety-eight cerebral hemorrhage patients in the convalescence period were involved in this study.Melancholia was assessed by Hamilton depression scale (HAMD),neural functional deficiency was assessed by the national institute of health stroke scale (NIHSS),cognitive function deficiency was assessed by the Montreal cognitive assessment (MoCA) and neural functional deficiency recovery was assessed by modified Rankin scale (mRS).Hemorrhagic site and blood quantity were detected with CT.The blood flow of middle cerebral artery (MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA) was detected by TCD.Results The melancholia incidence in the convalescence period was 51.0％(50/98),34.0％(17/50) in males and 68.8％(33/48) in females,there was significant difference between the two (P ＜ 0.05 ).The scores of NIHSS and mRS had significantly positive correlation with HAMD (P ＜ 0.05 ),and had significantly negative correlation with MoCA (P ＜ 0.05 ).When the hemorrhagic site was in frontal lobe and blood quantity was 20-40 ml,the melancholia incidence was increased [76.2％ (16/21),62.5％ (25/40)].The average blood velocity of MCA,ACA and PCA in melancholia patients was significantly slower than that without melancholia patients,while resistance index was significantly higher in melancholia patients (P ＜ 0.05).Conclusions Melancholia incidence in the convalescence period of cerebral hemorrhage has positive correlation with sex,NIHSS,MoCA,hemorrhagic site and blood quantity.The average cerebral blood flow in the melancholia patients is significantly slower and resistance index is significantly higher.

ObjectiveTo explore the safety and efficacy of endoscopic treatment for choledocholithiasis in patients with decompensated cirrhosis.MethodsA total of 104 cases of choledocholithiasis with decompensated cirrhosis were treated by ERCP in our hospital between January 2001 and March 2011.ChildPugh grading and model for end stage liver diseases (MELD) were investigated pre-ERCP and 2 weeks post-ERCP.Complication and mortality during the follow-up were recorded.ResultsThe success rates of complete stone retrieval was 92.3％ (96/104),and plastic stent was placed in other 8.Major complications ineluded post-ERCP bleeding in 9 cases (8.7％) and pancreatitis in 8 (7.7％ ).MELD score valuated 2weeks after ERCP ( 10.1 ± 6.3 ) was significantly lower than that of pre-ERCP ( 1 1.9 ± 6.2,t =2.22,P ＜0.05).The Child-Pugh grading before ERCP of 104 patients were 28 in grade A (26.9％ ),52 in grade B (50.0％ ) and 24 in grade C (23.1％ ),which was significantly different from those of 2 weeks after ERCP (40/52/12).No death was recorded during hospital stay for choledocholithiasis,and 2 patients of Child-Pugh grade C died in 3 months after discharge.ConclusionERCP is an effective method for choledocholi-thiasis in patients with decompensated cirrhosis.The main severe complication was post-ERCP bleeding.Those patients with decompensated cirrhosis would benefit from ERCP if we took effective measures.

Objective To evaluate the effect of pregnancy and delivery after renal transplantation (RT)on recipients,graft and offspring.Methods Clinical data of 6 pregnancies in 5 recipients were retrospectively studied and literature was reviewed.Results Among them,6 pregnancies and 4 deliveries occurred in 5 female RT recipients.The mean age at pregnancy was 31.1 years,with a mean interval between RT and pregnancy being 3.6 years.Preeclampsia developed in two pregnancies and hyperlipemia in one pregnancy.One RT recipient who discontinued immunosuppressant following pregnancy on her own exhibited subsequent renal failure.She underwent a second RT and delivered a healthy baby two years following the second RT.One RT recipient decreased the immunosuppressant dose to half after the pregnancy on her own and developed renal failure thereafter.Four patients underwent a Cesarean section at 38 th,35 th,35 th,and 38 th week,respectively.The mean birth weight was 3262.5 g with all Apgar scores of 10.Conclusion Our data coupled with prior reports suggest that for the recipients with normal renal function,successful pregnancy is achievable if immunosuppressant was taken correctly,but the pregnancy is at high risk,and careful monitoring is needed.