Humans ; Pulmonary Embolism ; diagnosis ; therapy ; Venous Thromboembolism ; diagnosis ; therapy

Objective To investigate the clinical features and genetic basis of cryopyrin-associated periodic syndrome (CAPS). Methods The clinical manifestations, laboratory tests, and genetic tests of one case of CAPS were retrospectively analyzed. The related literatures were reviewed. Results A 7 year and eight month old male patient had recurrent fever for 7 years and his whole body was covered with patchy red rash which was itchy and faded with pressure. The limbs and joints were normal. The levels of high-sensitivity C-reactive protein, erythrocyte sedimentation rate, rheumatoid factors were increased. The patient had fundus arteriosclerosis, double conjunctival lesions and nerve deafness on both sides. There was no mutation found in NLRP3 gene coding region, but a heterozygous mutation (-2667G>T) had been found in 5 ' untranslated region. Compared with normal control, the mRNA level of NLRP3 increased 4.2 times and the expressions of IL-1βand IL-18 gene increased 2.2 (P=0.002) and 1.2 times (P>0.05). Conclusions The clinical features of CAPS can be recurrent fever, rash, and joint involved. The oph-thalmologic abnormalities and varying degrees of deafness may occur during the progression. The test of NLRP3 gene may help diagnosis.

Schistosomiasis is a kind of zoonosis with serious hazard,which is popular in many countries and regions in the world. One of the efforts for schistosomiasis prevent and control is developing new drugs and vaccines,and knowing the tran?scription regulation mechanism and the function of transcription factors will help us find the targets of new drugs and vaccines as soon as possible. This article reviews the progress of Schistosoma transcription factors and research methods.

OBJECTIVE:To provide suggestions for the government decision of payment price of medicare drugs. METHODS:Investigation was conducted for the beginning of payment price policy of medicare drugs,effect of the implementation of policy in other countries and the encountered problems. The payment pricing mechanism was explored based on the combination of new medi-cal reform with theoretical analysis and empirical research. RESULTS:The reform of payment pricing mechanism of medicare drugs will have effect on current drug price,especially for R&D oriented pharmaceutical industries. The policy can decrease drug expendi-ture in medicare expenditure,and it is not sure whether it can decrease total medicare expenditure. CONCLUSIONS:It is suggest-ed to notice the related measures and government should keep balance between drug availability and encouraging R&D innovation.

To study the clinical efficacy of Pihui Fanggan Sachet (PHFGS), a sachet of traditional Chinese herbs, in preventing influenza and its immune regulation on mice.

Objective To summarize the clinical characteristics of primary pigmented nodular adrenocortical disease (PPNAD).Methods Eight patients with PPNAD from 2001 to 2009 in PUMC Hospital were reviewed,their clinical data were collected.Results PPNAD often occurred in adolescents.62.5% of patients with PPNAD were complicated with Carney complex(CNC).In addition to general features of Cushing's syndrome,amenorrhea and growth retardation in stature were very frequent in clinical manifestations of PPNAD.Plasma ACTH was undetectable,circadian rhythm of plasma cortisol was disappeared,glucocorticoid excretion was increased paradoxically during the dexamethasone suppression test in 50% patients with PPNAD.Adrenal imaging from 75% patients revealed normal-sized adrenal glands or suspectable micronodular changes.Adrenal pathologic analysis revealed numerous brown cortical nodules containing lipofuscin pigmentation.Unilateral adrenalectomy may relieve symptoms of Cushing's syndrome,but plasma ACTH and circadian rhythm of plasma cortisol were difficult to recovere.Hypercorticoidism might re-occure after unilateral adrenalectomy.Conclusion PPNAD should be bewared in ACTH independent Cushing's syndrome patients without apparent adrenal mass,and CNC should be screened and followed up.

Objective·To study the change of circulating endothelial progenitor cells (cEPCs) in acute ischemic stroke (AIS) patients within one week after attack,and the correlation of cEPCs with the prognosis.Methods·Ninty-two patients with AIS (AIS group) and 20 patients with risk factors (Risk group) were recruited.The proportion of cEPCs (CD34TKDR+ cells) in peripheral blood mononuclear cells of AIS patients was measured by flow cytometry (FCM) on the first day of admission and the seventh day after attack.Functional recovery was assessed by modified Rankin Scale (mRS) on the 90th day after onset.The cEPCs percentages of AIS patients with different mRS were compared to analyze their correlation.Results·Compared with Risk group,cEPCs percentage of AIS group on the 1st day of admission was lower (P=0.016).In AIS group,compared with poor prognosis group (mRS＞2),eEPCs percentage of good prognosis group on the 7th day after onset (mRS ≤ 2) elevates (P=0.002).The result of multiple linear regression showed that cEPCs percentage on the 7th day after onset was positively correlated with mRS on the 90th day (t=4.608,P=0.011).Conclusion·The percentage of cEPCs in peripheral blood of AIS patients decreases significantly during the acute phase.The percentage on the 7th day after onset is correlated with prognosis of AIS patients.

Objective To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). Methods A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled. Thirty-six healthy cases were enrolled as control during the same time. The levels of serum complement C3, C4 and C5b-9 on 1, 3 and 7 days after admission and myocardial function indicators were analyzed. Major adverse cardiovascular events (MACE) and readmission rate were analyzed after 1 year follow-up. The correlation between serum complement levels and myocardial function indicators was analyzed by Pearson correlation analysis. Results ① The levels of serum C3, C4 and C5b-9 on the first day in NSTE-ACS group and STEMI group were significantly higher than control group [C3 (g/L): 1.04±0.33, 1.26±0.35 vs. 0.39±0.21, C4 (g/L): 0.31±0.14, 0.33±0.10 vs. 0.19±0.07, C5b-9 (g/L): 575.46±197.26, 659.26±160.77 vs. 501.40±141.51, all P < 0.05]. There were no changes of serum C3, C4 in NSTE-ACS group, but C5b-9 decreased after a peak (g/L: 700.63±218.42) at 3 days. Serum complements in STEMI group reached peak on the third day [C3 (g/L): 1.37±0.33, C4 (g/L): 0.42±0.12, C5b-9 (g/L): 754.72±136.22]. The levels of serum C4 and C5b-9 in STEMI group were higher than NSTE-ACS group on the third and seventh day. ② The levels of troponin T (TnT), creatine kinase-MB (CK-MB), solution intercellular adhesion molecule-1 (sICAM-1), global registry of acute coronary events (GRACE) scores and percutaneous coronary intervention (PCI) numbers in STEMI group were significantly higher than those in the NSTE-ACS group, which were as opposite as left ventricular ejection fraction (LVEF). However, there were no significant differences in levels of serum N-terminal pro-brain nitric peptide (NT-proBNP), Fibrinogen (Fib), readmission rate and incidence of MACE between STEMI and NSTE-ACS groups. ③ According to GRACE, patients with ACS were divided into low risk group (≤ 108 scores, 26 cases), intermediate risk group (109-140 scores, 61 cases) and highest group (> 140 scores, 83 cases). TnT and sICAM-1 in intermediate risk group were significantly increased as compared with low risk group. Levels of TnT, sICAM-1, C3, C4 and C5b-9 in the highest group were significantly higher than the low and intermediate risk groups, however the lowest LVEF was found in the highest group. ④ It was shown by Pearson correlation analyses that levels of serum C3, C4, C5b-9 were positively correlated with TnT (r value was 0.481, 0.367, 0.292, respectively, all P <0.01), sICAM-1 (r value was 0.298, 0.249, 0.365, respectively, all P < 0.01), but negatively correlated with LVEF (r value was -0.384, -0.260, -0.200, respectively, all P < 0.01). In addition sICAM-1 positively correlated with TnT (r = 0.536, P = 0.000), but negatively correlated with LVEF (r = -0.341, P = 0.001). Conclusions Serum complements activation was found in the acute phase of ACS patients. Serum complement C3, C4 and C5b-9 are involved in the process of myocardial injury, and may reflect severity of myocardial injury and cardiac dysfunction.

BACKGROUND: Isoflavone isolated from Trifolium pratense L. has been found to be able to effectively inhibit bone resorption, reduce bone turnover rate, improve osteocyte activity and bone mineral density by enhancing the effect of estrogen, which is helpful for the prevention and treatment of osteoporosis. OBJECTIVE: To investigate the effect of Trifolium pratense L. extracts on the bone resorption and differentiation of osteoclasts.METHODS: Rat bone marrow cells were extracted, isolated by lymphocyte separation and cultured for 5 hours; then, the non-adherent cells were selected followed by induced by 30 μg/L macrophage colony stimulating factor and 75 μg/L RANKL (control groups), or different concentrations of Trifolium pratense L. extracts (0.3, 0.6 and 1.2 g/L) to observe their effect on the osteoclast differentiation and bone resorption. The levels of osteoclast differentiation-associated proteins c-fos and NFATcl were determined by western blot assay. RESULTS AND CONCLUSION: Compared with the control group, different concentrations of Trifolium pratense L. extracts could suppress osteoclast differentiation and bone resorption to different degrees. Tartrate-resistant acid phosphatase staining showed that Trifolium pratense L. extracts could significantly reduce the number of osteoclasts. Western blot assay results suggest that Trifolium pratense L. extracts significantly inhibited the expression levels of c-fos and NFATcl. These results reveal that Trifolium pratense L. extracts can inhibit osteoclast differentiation and bone resorption.

OBJECTIVE: To observe the clinical efficacy of highly agglutinative staphylococcin (HAS) combined with cisplatin in the treatment of malignant hydrothorax after straining and inserting central venous catheter in thoracic cavity. METHODS: 90 patients with malignant hydrothorax combined with lung cancer were randomly divided into A、B、C 3 groups. Central venous catheter was inserted in thoracic cavity for strainage. Group A were intrapleural injected with 5 000 U HAS, group B 40 mg?m-2 cisplatin and group C 5 000 U HAS combined with 40 mg?m-2 cisplatin once a week. Clinical efficacies of 3 groups were evaluated after 3 weeks of treatment. RESULTS: The total effective rate of group A, B and C were 43.0%, 46.7% and 80.0% respectively. There was obvious difference between group C and A as well as group B(P