Objective To investigate the early diagnostic value of serum Cystatin C in the diagnosis of acute kidney injury (AKI) in critically ill children.Methods Ninety-eight children of the severe case patients' rooms were divided into two groups:33 cases were AKI,65 cases were NAKI.Cystatin C and SCr in blood serum were detected by immunoturbidimetry and enzymic method every day.And compared serum Cystatin C,SCr concentrate and median diagnosis time between the two groups.Results Thirty-three cases in 98 cases of critically ill children occurred the AKI,65 patients without AKI.Comparing with the NAKI,the Cystatin C of AKI patients were significantly higher ((2.68 ±0.86) mg/L vs (0.76 ±0.15) mg/L) and SCr ((209.21 ± 100.53 ) μmol/L vs (77.46 ± 8.11) μmol/L),the differences were statistically significant (t =10.55,17.56,P ＜0.001) ; Cystatin C was in positive correlation with SCr (r =0.874,P ＜ 0.001) ; Median diagnosis time of AKI-Ⅰ,Ⅱ,and Ⅲ stage with Cystatin C were (3.0 ± 2.5) d,(5.0 ± 3.0) d and (9.0 ± 4.0) d,respectively,which was earlier than that of SCr ((5.0 ± 2.0) d,(7.0 ± 2.5) d and (10.0 ± 3.0) d,respectively; t =4.39,2.29,3.16,respectively ;P ＜ 0.01 or P ＜ 0.05).Conclusion In the process of AKI,the level of serum Cystatin C elevated significantly earlier than SCr,so it could as be one of the early dynamic criteria in the critically ill children.

Objective To assess the efficacy and safety of paroxetine for epileptic patients following depression. Methods 156 epileptic patients were recruited. Patient Health Questionnaire 9-item Depression scale (PHQ-9) then the Hamilton Scale for Depression (HAMD)were the assessment tools. 31 patients, whose score of PHQ-9 more than 15 and HAMD more than 20 were selected. The monthly seizure frequency and depression severity were investigated before and 12 weeks after treatment with paroxetine, 20 mg/d. The side effects of paroxetine were also observed. Results 29 patients completed the observation. The total scores of the HAMD decreased 12 weeks after treatment (P<0.05). Dizziness was the most common adverse event during the first month of treatment. No seizure worsening was observed. Monthly seizure frequency did not change significantly. Conclusion Paroxetine is a safe and effective antidepressant for epileptic patients following depression.

The significance of the performance of conventional in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) using sibling oocytes from couples with subfertile male or unexplained infertility was evaluated. A total of 410 sibling oocyte cumulus-corona complexes (OCCC) from 21 couples with subfertile male (group A) and 11 unexplained infertile couples (group B) were randomly divided, in order of retrieval, into two groups inseminated either by conventional IVF or by ICSI. The treatment outcomes and the influence of infertility factors on fertilization in each group were compared. The results showed that although the two pronuclear (2PN) fertilization rate per injected sibling oocytes was significantly higher after ICSI (group A: 68.2% +/- 28.8%; group B: 66.2% +/- 24.9%) than after conventional IVF (group A: 41.8% +/- 32.7%; group B: 40.1% +/- 22.1%), the other variables studied included: the fertilization rates of per allocated sibling oocytes IVF/ICSI, the fertilization rates of sibling oocytes IVF/ICSI after excluding failed IVF fertilization cycles, as well as the cleavage rates of normal fertilization were not statistically significant (P>0.05). Similarly, though the total fertilization failure rate in the IVF group (group A: 42.9%; group B: 36.4%) was significantly higher than in the ICSI group (group A: 4.8%; group B: 0), we did not cancel cycles due to the normal fertilization of sibling oocytes. Embryo transfer was possible in all 32 couples. There were 10 clinical pregnancies in the two groups. We also discovered a possible association between some semen parameters and sperm functions of group A, and women age and duration of infertility of group B and fertilization. It is suggested that adoption of the split IVF/ICSI technology in the above cases may help eliminate fertilization failures. This is also a useful method to investigate the effect of single factor on the employment of assisted reproductive technology.
Embryo Transfer ; Fertilization/*physiology ; *Fertilization in Vitro ; Infertility, Male/*therapy ; Oocytes/*physiology ; Semen/physiology ; Siblings ; Sperm Count ; *Sperm Injections, Intracytoplasmic ; Sperm Motility/physiology

OBJECTIVETo observe the influence of decreasing conditioning regimen intensity on the engraftment of HLA haplotype peripheral blood stem cell transplantation.

METHODTwelve patients with leukemia, including 4 in complete remission, whose HLAs were full matched with donors, and 8 with refractory leukemia, whose HLAs were mismatched, were transplanted with G-CSF mobilized allogeneic peripheral blood stem cells after conditioned with a regimen consisting of fludarabine (30 mg/m(2) x 6 days), busulfan (4 mg/kg x 2 days) and cyclophosphamide (30 approximately 60 mg/kg x 2 days) (FBC). Donor lymphocytes were infused at day + 30, + 60 and + 90 after transplantation, respectively. Hematopoietic reconstitution was observed. Engraftment was documented by the analysis of short tandem repeats with polymerase chain reaction (STR-PCR).

RESULTPatients in HLA haplotype group received a mean number of 4.87 x 10(8)/kg donor mononuclear cells (MNC), with CD(34)(+) cells of 4.58 x 10(6)/kg and patients in HLA identical group a mean number of 4.85 x 10(8)/kg MNC with CD(34)(+) cells of 4.47 x 10(6)/kg. The mean time of white blood cell count more than 1.0 x 10(9)/L was 14 (10 approximately 18) days in HLA matched patients and 29 (11 approximately 90) days in HLA haplotype group. One three locus mismatched patient failed to engraft, but auto-hematopoiesis was recovered on day + 50. Full donor chimerism was observed in all patients except one with mixed chimera. The mixed chimera was converted into full donor chimera after three times donor lymphocyte infusion. One each died from severe acute GVHD, severe VOD and severe chronic GVHD in HLA haplotype group, and one from chronic GVHD in HLA identical group.

CONCLUSIONPatients survived engraftment was not influenced by decreasing conditioning intensity as in this regimen. Haplotype stem cells could be engrafted durable in recipients by this regimen combined with donor lymphocyte infusion.

Adolescent ; Adult ; Busulfan ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Female ; Graft Survival ; drug effects ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Humans ; Immunosuppressive Agents ; therapeutic use ; Leukemia ; therapy ; Male ; Middle Aged ; Transplantation Conditioning ; Transplantation Tolerance ; drug effects ; Vidarabine ; analogs & derivatives ; therapeutic use

The significance of the performance of conventional in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) using sibling oocytes from couples with subfertile male or unexplained infertility was evaluated. A total of 410 sibling oocyte cumulus-corona complexes (OCCC) from 21 couples with subfertile male (group A) and 11 unexplained infertile couples (group B) were randomly divided, in order of retrieval, into two groups inseminated either by conventional IVF or by ICSI. The treatment outcomes and the influence of infertility factors on fertilization in each group were compared. The results showed that although the two pronuclear (2PN) fertilization rate per injected sibling oocytes was significantly higher after ICSI (group A: 68.2% +/- 28.8%; group B: 66.2% +/- 24.9%) than after conventional IVF (group A: 41.8% +/- 32.7%; group B: 40.1% +/- 22.1%), the other variables studied included: the fertilization rates of per allocated sibling oocytes IVF/ICSI, the fertilization rates of sibling oocytes IVF/ICSI after excluding failed IVF fertilization cycles, as well as the cleavage rates of normal fertilization were not statistically significant (P>0.05). Similarly, though the total fertilization failure rate in the IVF group (group A: 42.9%; group B: 36.4%) was significantly higher than in the ICSI group (group A: 4.8%; group B: 0), we did not cancel cycles due to the normal fertilization of sibling oocytes. Embryo transfer was possible in all 32 couples. There were 10 clinical pregnancies in the two groups. We also discovered a possible association between some semen parameters and sperm functions of group A, and women age and duration of infertility of group B and fertilization. It is suggested that adoption of the split IVF/ICSI technology in the above cases may help eliminate fertilization failures. This is also a useful method to investigate the effect of single factor on the employment of assisted reproductive technology.
Embryo Transfer ; Female ; Fertilization ; physiology ; Fertilization in Vitro ; Humans ; Infertility, Male ; therapy ; Male ; Oocytes ; physiology ; Semen ; physiology ; Siblings ; Sperm Count ; Sperm Injections, Intracytoplasmic ; Sperm Motility ; physiology

Objective To evaluate the effects of community-based rehabilitation therapy on activitv of daily living performance of the Chinese stroke patients. Methods In a single blinded,randomized,controlled multicenter trial,737 consecutive stroke patients were stratified by two groups of cerebral infarction and hemorrhage. All the patients were randomly divided into a rehabilitation group and a control group.The patients in the rehabilitation group received atandardized community-based rehabilitation therapy,while those in the control group did not.All the patients were followed up for 5 months for evaluation of their performance with activity of daily living by using Modified Barthel Index before intervention,after follow-up 2 and 5 months,respectively. Results Patients in the rehabilitation group performed better in ADL as reflected by the Modified Barthel Index score than those in the control group after 5 months of intervention(P＜0.05).Although both the rehabilitation group and control group improved over time,the rehabilitation group showed a greater improvement with the Modified Barthel Index scores when compared with the control group(P＜0.01).After 5 months follow-up,the total gain of Modified Barthel Index scores was 26.28 and 32.89 for those with cerebral infarction and hemorrhage,respectively,in the rehabilitation group. In comparison,the gain of Modified Barthel Index scores was 7.65 and 2 1.70 for those with cerebral infarction and those with hemorrhage,respectively in the control group.This implies a difference in improvement of 1 8.63 in cerebral infarction group and 1 1.19 in hemorrhage group,in favor of the rehabilitation group. Conclusion Standardized community-based rehabilitation therapy may help stroke patients to improve their performance in activity of daily living significantly.

Objective The age and seasonal variation in children's serum 25-hydroxyvitamin D (25(OH) D] were analyzed retrospective and to provide some guides on clinical application.Methods The serum 25(OH) D level was detected by using enzyme-linked immunosorbent assay kit in 13 502 children that took health examination in Guangzhou Women and Children's Medical Center in February,march,September and October from 2009 to 2011.The cases were divided into five age groups.The average levels,deficiency and overdose of vitamin D (VD),were analyzed.Results The average 25(OH)D in serum was (80.81±42.39) nmol/L in 13 502 cases,(72.71 ± 33.47) nmol/L in Feb.and Mar.group,(89.91 ± 49.01) nmol/L in Sep.and Oct.group.There was statistically significant difference on serum 25 (OH)D level between seasons and between boys and girls for 6 years older groups.The serum 25 (OH) D levels significantly decreased with increasing age.There were statistically significant differences in serum 25 (OH) D levels and between the VD deficiency and the lack of number of cases in the 5 age groups of the two seasons.The number of VD deficiency was 482 cases (3.57％) whose 25 (OH) D ＜ 37.5 nmol/L,and 1850 cases (13.7％) whose 25 (OH) D ＜ 50.0 nmol/L.The VD deficiency in each age group was 8.19％,13.97％,37.72％,52.63％,57.92％ in Spring,and 2.38％,4.15％,10.36％,16.85％,27.47％ in Summer.The number of lack of VD was in 6 973 cases (51.64％);Excessive and poisoning of VD were 34 cases (0.25％) and 35 cases (0.26％).Conclusions Children had a relatively low level of VD in Guangzhou area,especially in the spring and school-age children with more severe VD deficiency.It is necessary to supplyVD timely in accordance with the age and season,and children were encouraged to spend more time outdoors.

The authors have retracted this article (Xiao et al., 2018). After publication, they became aware that a number of studies included in the meta-analysis did not meet the eligibility criteria and that errors were made in classification and statistical analysis. The conclusions presented are therefore unreliable. All authors agree with this retraction.