Bruton tyrosine kinase (Btk) is a member of the non-receptor protein tyrosine kinases of Tec family.It plays an important role in growth,proliferation,differentiation and signal transduction of B lymphocyte.After activation of B-cell receptor (BCR) by diverse stimuli,Btk is activated through tyrosine phosphorylation.Activated Btk can stimulate several downstream signaling proteins.Btk and BCR signaling pathways play important roles in initiation and maintenance of B cell malignancies.This review focuses on the recent findings in association of Btk and B cell malignancies.

Objective To investigate the immune disorder in elderly patients with severe ischemic stroke and to explore whether a new type of diabetes-specific enteral nutrition formula can regulate the immune function of these patients.Methods In the randomized controlled prospective study,90 patients aged 60-80 years with acute ischemic stroke and NIHSS score more than 10 and dysphagia were randomized to two groups:receiving a new type(Group A) of,versus traditional(Group B) diabetes-specific enteral nutrition.30 Patients aged 60-80 years with acute ischemic stroke and NIHSS score ≥10 without dysphagia were enrolled as control(Group C).The immune function was observed,and the nutritional status and immunological function were compared between two different enteral nutrition groups at 7 days of treatment.Results After 7 day follow-up,the serum lipid stats significantly ameliorated in group A.An obvious suppression of immune state was observed in severe acute ischemic patients at onset of 7 days.At day 7 of treatment,the percentage of CD3+ T cells in group A was(69.25±9.93)％ after treatment vs.(63.36±7.79)％ at baseline(P＜0.001),and CD3 +CD4+T cells was(45.79±9.47)％ after treatment vs.(36.12±9.15)％ at baseline(P＜0.001),as well as CD4+/CD8+ cells were(2.27±1.40)％ after treatment vs.(1.70±0.82)％ at baseline(P=0.001).At 7 days of treatment,the percentage of CD3+ T cells was higher in group A (69.25 ±9.93) ％ than in group B(63.07± 9.47) ％ (P＜0.001),and the percentage of CD3 + CD4 cells was higher in group A(45.79 ± 9.47) ％ than in group B(41.32 ± 8.89) ％ (P=0.024).Conclusions Enteral nutrition preparations can provide sufficient energy support in the acute ischemic stroke.Immunosuppressive state exists in patients with acute phase of severe ischemic stroke.The new type of diabetic enteral nutrition formula can significantly improve immunosuppressive state in patients with acute severe stroke.

Objective To assess the public health service quality objectively in Shenzhen,and promote the equity of basic public health services.Methods The criterion and method of the assessment were established by municipal health administrative department,the assessment of institutions and regions were conducted by experts selected by municipal professional institutions.Regional assessment was the comprehensive evaluation of public health service qualities of professional public health institutions,medical institutions and the community health centers.The assessment of the degree of public health service quality satisfaction was accomplished by a third-party institution.Results The accomplishment ratio of indicators for public health service quality was 93.2％.This ratio has witnessed a high increase with mental health institutions,occupational disease prevention and control institutions and health education institutions on one hand.On the other,it has dropped with institutions of disease control,chronic disease control and medical institutions within the region.On the whole,this ratio has increased with all the districts to different extents.Despite the overall improvement of public health capabilities citywide,imbalances are found among districts and institutions as well.Conclusion It is imperative to further improve the public health service system and equity while carrying out specific tasks in this respect.

Objective By analyzing the clinical and radiographic manifestations of calcium pyrophosphate deposition disease (CPDD) to improve the recognization of the disease.Methods Clinical features,diagnosis and treatment of an old female patient with CPDD was reported with literature review.Results An old female patient presented with swollen and pain on the right knee without obvious causes eight years ago,which was characterized by slightly reddness of joint surface,warm of local skin.Thcn she gradually developed swollen and pain in left knee,right ankle,both wrists,bilateral meta-carpophalangeal (MCPJ) and right elbow joints with few joint symptoms and the joints swollen and pain could relieved spontaneouslyitself in about one week.X-ray showed the thin strip of cartilage calcifications in wrist triangular fibrocartilage disc,meniscus of knee and the pubic symphysis were parallel to the surface of cartilage.Examination of microscopy with refractive filter demonstrated that short rod crystals refraction in joint fluid.CPDD was diagnosed and treated with flushing of joint cavity and injections of betamethasone as well as nonsteroidal anti-inflammatory drug orally.Symptoms relieved after therapy.Conclusion Understanding the disease characteristics of CPDD is beneficial to for accurate diagnosis and treatment.

Berberine is an isoquinoline alkaloid isolated from Rhizoma Coptidis and Cortex Phellodendri,which has a long medical history in China.Recent studies have indicated that berberine has multiple pharmacological activities including anti-inflammatory,anti-microorganisms,anti-cancer,cardiac protection,glucose lowering,regulating lipid metabolism and immune suppression.Berberine has been used for the treatment of intestinal infectious diseases for many years.With the continuous progress of the research,it is reported that berberine has many new clinical applications,including treatment of the cardiovascular disease,metabolic syndrome and its complications,cancers,abdominal adhesions and chlamydia trachomatis infection.This review is intended to introduce the role of berberine in various aspects of pharmacological effects,molecular mechanisms and clinical applications.

OBJECTIVE To analyze the isolation rate and four consecutive years′(2004-2007) antibiotic-resistance trend of extended-spectrum ?-lactamases(ESBLs) producing Escherichia coli in urinary tract infection and to provide evidence for anti-infection therapy.METHODS The anti-microbial susceptibility test results of E.coli cultured from the midstream urine of outpatients and inpatients of our hospital from 2004 to 2007 were collected.Whonet 5.4 statistical analysis software was used for analysis.RESULTS During four years,no apparent change has been shown about antibiotic resistant rate of ESBLs producing E.coli.The isolation rate of this kind of E.coli increased year by year from 31% to 44% and showed high resistance to third generation cephalosporins and quinolones antibiotics,but was 100% sensitive to imipenem.CONCLUSIONS With the ESBLs-producing E.coli increasing year by year,the antibiotic-resistance rate of E.coli isolated from urinary tract infection is apparently increased and thus screening of antibiotics sensitive to enzyme-producing bacterial is the key point when the empirical therapy especially when the third and fourth generation cephalosporins are ineffective.

Brain Neoplasms ; pathology ; Glioma ; pathology ; Humans ; Infant, Newborn ; Male

10.3969/j.issn.1000-3606.2013.06.004

Objective To analyze the clinical characteristic s of an infant with congenital lipoid adrenal hyperplasia (CLAH),and to sequence the acute regulatory protein (steroid acute regulatory,StAR) gene of the infant patient and her pedigree.Methods Physical examination,laboratory tests,and imaging examination of the 11-month-old patient with CLAH were collected.DNA was extracted from blood samples of the patient and her parents.The 7 exons of StAR gene were amplified by PCR and then sequenced.Results Dark skin,girl vulva,and one each 1.0 cm×1.0 cm palpable lump in inguinal area bilaterally were observed.The adrenocorticotropic hormone (ACTH) was 253 pg/ml,cortisol was 27.6 nmol/L at 8 am,17-hydroxyprogesterone was 3 nmol/L.Uhrasound showed that sign of testicular ultrasonography existed in bilateral inguinal regions.Karyotype analysis showed 46,XY.Sequencing of PCR amplified fragments showed that there were two heterozygous mutations c.229C ＞ T,p (Gln77X) and C.659A＞G,p (His220Arg) of StAR gene in this patient.By rectifying the disturbance of electrolyte,and treating with hydrocortisone and 9α fludrocortisone,etc,the patient has been stable so far.Conclusion The patient presents typical clinical manifestations.Two heterozygous mutations including c.229C ＞T,p (Gln77X) from maternal and C.659A＞G,p (His220Arg) from paternal of StAR gene were detected.Wherein the c.659A＞G,p.(His220Arg) as a novel point mutation of StAR gene,has not been reported so far.

Objective To investigate the accuracy of predicting middle cerebral artery infaction with contin -ue electroencephalograph .Methods 40 cases with middle cerebral artery infaction were divided into malignant groups(14) and binigan groups(26).They were all with continued beside electroencephalograph within 24 hours after admission.Results Abnormal CEEG rate in malignant groups [85.71%(12/14)]was significantly higher than that in binigan groups[65.38%(17/26)](χ2 =10.405,P=0.001).In malignant groups,severe abnormal CEEG was seen in 4 cases developed coma at the second day of admission ,moderate abnormal CEEG was found in 6 cases,slight abnormal CEEG was detected in 2 cases,normal CEEG was detected in 2 cases.Conclusion Early CEEG has a cer-tain value for predicting middle cerebral artery infaction .