Moyamoya disease is a chronic progressive cerebrovascular disease. Its main manifestation is bilateral internal carotid artery progressive stenosis w ith abnormal vascular netw ork formation of the compensatory hyperplasia in brain base. The pathological mechanism of moyamoya disease is not clear. Grow ing evidence has suggested that immune inflammation may play an important role in its occurrence and development process. Abnormal expression of various inflammatory cytokines and immune proteins can be observed in patients w ith moyamoya disease. This article review s the possible mechanism of immune inflammation in moyamoya disease in recent years.

High mobility group protein box 1 (HMGB1) is a typical nonhistone chromosomal protein. It has many celular functions in nucleus. Studies in recent years have showed that HMGB1 can be released to the outside of cels to exert a wide range of cytological effects. Ischemic stroke is one of the diseases with the highest morbidity and disability. More and more evidence has shown that HMGB1 plays a variety of important roles in the occurrence and development process of ischemic stroke. This article reviews the roles of HMGB1 in ischemic stroke.

Ischemic stroke is one of the diseases with the highest morbidity and disability.Hypertension is recognized as the most important independent risk factor for ischemic stroke.Vascular remodeling during the development of hypertension is the pathological basis of causing ischemic stroke.Studies have shown that vascular smooth muscle cell proliferation and apoptosis will lead to vascular remodeling.In addition,cerebral ischemia-reperfusion can result in neuronal damage and apoptosis.Recent research has shown that vascular remodeling and neuronal apoptosis are associated with chloride channels.At least 3 chloride channels including volume regulated chloride channel,calcium activated chloride channel and cystic fibrosis transmembrane conductance regulator are involved in these processes.This article reviews the roles of the 3 chloride channels in vascular remodeling,neuronal apoptosis,and ischemic stroke.

Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.

Objectives Understanding the characteristic changes of Keshan disease (KD) in different epidemic period to provide reference basis for prevention and teatment. Methods On the basis of medical record as fundamental element, the relative conditions of Keshan disease's prevailing and spreading period were compared. Results In high incidence years, familial aggregation [accounted for 12%(6/50)] and seasonal aggregation were found, and KD cases occurred mainly from May to September, which was 78% (39/50)of the total cases in the whole year. Circulatory dysfunction(gallop rhythm, pulmonary role, jugular venous engorgement, cyanosis of lips) was more severe in high incidence years than that in low incidence years(X2=8.53,P<0.01). The average age of incidence was (4.07±1.46) years old in high incidence years and (6.11±2.71) years old in low incidence years. The type constitution in high incidence years was significantly different from that in low incidence years (X2=40.68, P<0.01), and chronic type of KD accounted for 22.85%(707/3094),46.09%(53/115), respectively, in high and low incidence years. Conclusions Making a further research of seizure of disease, and improving diagnosis and cure management level are also the important content for prevention and cure research work of Keshan disease at right time.

Adrenal Hyperplasia, Congenital ; diagnosis ; Female ; Humans ; Infant, Newborn ; Male ; Neonatology ; Pregnancy ; Prenatal Diagnosis

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

The implantable axial blood pump, driven by external electromagnet, is studied recently. It oscillats when it is running because of the elastic implanted environment and driving force disequilibrium, etc. In this paper, a model of single erythrocyte in vibrated flow field was built to simulate the deformation and force of the erythrocyte. By using the mechanical injury principle of blood in blood pump, we studied the injury of a single erythrocyte resulted from oscillating boundary flow field. The research results indicated that the shape of the erythrocyte, force and velocity field nearby, which are affected by oscillating boundary flow field, all cause injury to the erythrocyte. All the researches shown in the present paper are expected to provide theoretical foundation for lightening hemolysis by the blood pump.
Assisted Circulation ; Erythrocytes ; cytology ; Hemolysis ; Humans ; Models, Cardiovascular ; Oscillometry ; Prostheses and Implants

Objective To explore clinical features and drug sensitivity of Streptococcus pneumoniae (SP) isolated from pediatric patients with lower respiratory tract infection, and to provide evidence for clinical use of antibiotics. Methods A total of 6 358 clinical SP isolates from children with lower respiratory tract infection from January 2008 to December 2012 were col-lected and retrospectively analyzed. The antibiotic sensitivity was done by Kirby-Bauer method and E-test, and all results were in strict accordance with the rules of CLSI. Results The isolated SP strains were mainly from different departments of pediatrics. All clinical cases with SP infection mainly included pneumonia and bronchitis. The resistance rates of 6 358 SP strains to penicil-lin, cefotaxime, erythromycin, clindamycin, cotrimoxazole, tetracycline, chloramphenicol, levolfoxacin, vancomycin were 5.0%, 12.9%, 98.7%, 96.0%, 92.2%, 7.3%, 5.6%, 0.2%and 0.0%respectively, and the resistance rate to penicillin and cefotaxime was signiifcantly different in every years (all P<0.05). The resistance rates of the 318 penicillin-resistant SP strains to the above anti-biotics were 100.0%, 42.6%, 100.0%, 100.0%, 99.2%, 23.6%, 6.8%, 0.6%, 0.0%respectively, and the resistance rate to penicillin and cefotaxime was signiifcantly different (P=0.001). Conclusions The antibiotic resistance rates of SP strains isolated from children with lower respiratory tract infection were higher to erythromycin, clindamycin, cotrimoxazole and tetracycline, and an increasing rate in drug resistance to cefotaxime was observed in recent years. Appropriate antibiotics should be selected for the treatment of infection according to drug sensitivity.

Objective To explore the effects of behavioral inhibition system/activation system (BIS/BAS) and emotion regulations on depression of adolescents.Methods 800 adolescents from an university and a middle school were chosen by cluster random sampling,and were surveyed by BIS/BAS scale,Beck depression inventory(BDI),center for epidemiologic studies depression scale (CESD) and cognitive emotion regulation questionnaire (CERQ).The data were analyzed by pearson correlation,F test and multiple stepwise regression analysis.Results (1) BDI and CESD were correlated positively with BIS (r =0.39,0.41,P ＜ 0.01),self-blame,rumination,catastrophizing,blame others and perspective(r =0.19-0.50,P ＜ 0.05-0.01),and negatively with planning,reappraisal (r =-0.08-0.24,P＜0.05).(2)The scores of severe depression group were highest(15.45 ±2.57,P＜0.01) in BIS,lowest in BAS-drive(9.60 ±2.99,P＜0.01),and nonadaptive emotion regulations were used mostly,and adaptive emotion regulations were done leastly.(3) Catastrophizing,BIS,reappraisal,rumination,refocusing and self-blame explained 35％ of total variance,and catastrophizing and BIS explained the largest proportion,respectively 25％ and 4％.Conclusion BIS/BAS and emotion regulations may be important factors influencing non-clinical depression of adolescents.