Objective To explore the clinical significance of mycoplasma pneumoniae(MP) antibody IgM positive with high titers.Methods Two hundred and sixty-seven cases of respiratory tract infections of MP with MP-IgM positive were confirmed in our hospital during Jun.2005 to Aug.2008,of which 63 cases with significantly increased titers of MP-IgM antibodies(MP-IgM≥1:1 280).A prospective observation and later analysis of the clinical manifestations of the 63 cases were carried out.Results 1.Among 63 cases,6 cases were diagnosed as upper respiratory tract infection,12 cases as acute bronchitis and 45 cases as pneumonia,respectively.2.The 63 cases pre-sented mainly with fever and cough,of them 59 cases had fever and 45 cases with paroxysmal cough,39 cases could be found crackles on physical examination.3.Extrapulmonary manifestations could be found in many cases,including heart complications in 21 cases,abnormal liver functions in 35 cases,gastrointestinal manifestations in 22 cases,neurological manifestations in 1 case,dermatological disorders in 7 cases and renal manifestations in 3 cases.4.Patterns of chest X-ray findings of the 63 cases with MP infections were varied,of which 45 cases showed pulmonary abnormality.Chest X-ray findings of the 45 children included 12 cases with interstitial infiltration,6 cases with lobar condensation,15 cases with patch shadows,4 cases with enlarged porta pulmonis and 8 cases with reticulonodular infiltrates.Three cases were complicated with pleural effusion and 2 children with segmental atelectasis.5.The cases were given azithromycin,10 mg/(kg?d),a daily dose for 5 days and intermitted for 4 days.All cases repeated the treatment courses for 1 to 4 times.The mean duration of fever was 6.6 days,cough could last 11.7 days and the crackles on physical examination could not be found 7.5 days later after treatment.The abnormality of chest X-ray findings dissolved in 38 cases 2-3 weeks later after treatment.Conclusions Cases of MP infections with high titers of MP-IgM positive had severe symptoms,of which more than 90% patients presenting with lower respiratory tract infections,mainly with pneumonia.Recovery of chest radiological finding was posterior to clinical improvement,so timely and regular chest X-ray examinations were essential after treatment and could avoid the false ceasing of treatment of the cases.Patients of MP infections with high titers of IgM antibodies positive have good prognosis.

Objective To analyze the trend of disease constitution of hospitalized neonates in China-Japan Friendship Hospital and provide a scientific basis for the focus adjustment of perinatal health.Methods Six hundred and ninety-eight neonates were admitted during Jan.2004 to Dec.2008.Relevant data of all cases were retrospectively collected.The discharge diagnosis of the neonates was counted accor-ding to the year,and the trends of the neonatal disease constitution of the 5 years were analyzed.Results 1.The first 10 diseases of hospita-lized neonates were centralized,and the first 3 diseases including premature infants,neonatal hypoxic-ischemic encephalopathy(HIE) and neonatal hyperbilirubinemia accounted for 42.84% of the neonate diseases.2.The characteristics of neonatal disease constitution were as fo-llows:the disease constitution of premature infants always located within the first 3 diseases;the location of neonatal HIE went ahead from number 8 to number 1 or 2,and its constitution proportion increased from 4.93% to more than 15.00%(P

OBJECTIVE To investigate the effect of furanodiene(FDE),a diterpene derived from the medicinal plant Zedoary,on apoptosis of human gastric cancer MGC-803 cells induced in vitro. METHODS MGC-803 cells were treated with FDE 46.29~740.74μmol·L-1 for 24,48 and 72 h,and the cell viability was detected with MTT assay. Cell morphology was observed by light microscopy and Hoechst33342 staining. Flow cytometry was used to detect cell apoptotic rate and cell cycle. Rh123 staining and fluorescence probe DCFH-DA were employed to detect the changes in mitochondrial membrane potential (MMP) and reactive oxygen species(ROS). RESULTS MTT Results showed that FDE 46.29-740.74μmol · L-1 exhibited significantly higher cytotoxicity to gastric cancer MGC-803 cells. IC50 for MGC-803 of 24,48 and 72 h treatment was 347.91,257.41 and 101.01μmol·L-1,respectively. Treatment with FDE 92.58-370.32μmol·L-1 for 24 h also caused significant morphological changes in MGC-803 cells. AnnexinⅤ-FITC/PI double staining showed that the apoptotic rate increased after FDE 92.58-370.32μmol·L-1 treatment for 24 h(P<0.05). FDE enabled MGC-803 cell cycle arrest in S phase. DCFH-DA staining showed that FDE resulted in an increase in intracellular ROS levels(P<0.05) when PDE concentration was 370.37μmol·L-1(P<0.05). MMP decreased after FDE treatment when PDE concen?tration was 370.37μmol·L-1(P<0.05). CONCLUSION FDE Possesses potent tumor selected toxicity and can induce apoptosis of MGC-803 cells through cell cycle arresting,which is related to inhibition of DNA biosynthesis.

BACKGROUND: Hyperhomocysteinemia has been suggested to be a possible independent risk factor for stroke.OBJECTIVE: To explore the relationship between hyperhomocysteinemia and cerebral infarction and hemorrhage, and analyze the factors that affect plasma homocysteine level.DESIGN: Case-controlled clinical trial.SETTING: Department of Neurology, Second Hospital Affiliated to Medical College of Zhejiang University.PARTICIPANTS: Totally 57 patients including 21 with cerebral hemorthage and 36 with brain infarction were treated in the Department of Neurology, Second Hospital Affiliated to Medical College of Zhejiang University Between January and November 2003. Twenty-eight healthy volunteers were also recruited from the subjects coming for routine physical examination.METHODS: Two milliliters of fasting venous blood was collected from all subjects in the morning for detecting the contents of plasma homocysteine,vitamin B12, folic acid, creatinine and so on. All patients were scored for clinical neurological impairment, with the hematoma volume calculated in patients with brain hemorrhage determined on the basis of CT scanning.acid, vitamin B12, clinical neurological impairment score and hematoma volume.RESULTS: Valid results were obtained from all the 57 stroke patients and in male and female patients of both cerebral infarction group and cerebral hemorrhage group than that of the subjects of the same gender in the control group [(25.2±21.4), (18.3±10.9), (11.5±2.9) μmol/L for male subjects;(22.8±18.9), (14.7±7.4), (10.8±2.6) μmol/L for female subjects, P＜ 0.05-0.01].The level of homocysteine was similar between cerebral infarction group and cerebral hemorrhage group, homocysteic acid level showed obvious inverse correlation with folic acid level (r=-0.442, -0.531, P ＜ 0.05), but without relation to vitamin B12 level (r=-0.086, -0.111, P ＞ 0.05). Homocysteine level was not obviously correlated to the neurological impairment scores in cerebral infarction group (r=-0.139, P ＞ 0.05), nor was it related to the scores or hematoma volume in cerebral hemorrhage group (r=0.225,0.425, P ＞ 0.05).CONCLUSION: Hyperhomocysteinemia is risk factor for cerebral infarction and hemorrhage. Plasma homocysteine level is inversely correlated with folic acid level, but not obviously related to vitamin B12, clinical neurologicla impairment score or hematoma volume.

Joint contracture is currently one of the very common diseases in rehabilitation medicine department.Once it occurs,it likely leads to such functional disturbances in the patients as restricted joint activities,decreased muscle strength around a joint and abnormal gait,seriously affecting the quality of life of the patients.Studies on its pathogenesis can help doctors better understand and treat the disease.In this paper,pathogenesis of the disease and progress in its therapy are summarized.

Objective:To evaluate the value of Cook MOB-15 system in guiding wire insertion during endoscopic retrograde cholangiopancreatography (ERCP). Methods: The clinical data of 51 patients who received Cook MOB-15 system-guided wire insertion during ERCP between Jan. 2005 to Dec. 2007 were retrospectively analyzed. Forty patients who received conventional ERCP catheter for malignant jaundice between Jan. 2002 and Dec. 2004 were taken as control. The successful insertion rates were compared between the 2 groups. Results: The successful insertion rate was 90.2% (46/51) in the Cook MOB-15 system group and 72.5% (29/40) in the conventional group; there was significant difference between the 2 groups (P

BACKGROUND:Previous research indicated that iron-fluorouracil-phenanthroline complex has good antitumor activity in vitro, which can inhibit the proliferation of human cancer cels. OBJECTIVE:To detect the antitumor activity and toxicity of iron-fluouracil-phenanthroline complex, [Fe(5-Fu)2(Phen)SO4],in vivo. METHODS:A total of 40 Kunming mice were randomly divided into four groups, which were intraperitoneally injected with 72, 102.9, 147, 210 mg/kg [Fe(5-Fu)2(Phen)SO4] and the half lethal dose of the complex was detected. One day after the establishment of mouse S180 sarcoma models, the model mice were randomly divided into eight groups, and administered with the intraperitoneal injection of 15 mg/kg (low dose group), 30 mg/kg (middle dose group), 60 mg/kg (high dose group) [Fe(5-Fu)2(Phen)SO4], normal saline (negative control group), cisplatin (positive control group), 5-fluorouracil, iron-salt and phenanthroline, respectively. The injection was done once a day, lasting for 7 days. The weight of sarcomas, body weight, the main organ coefficient and histopathological changes of the main organs were detected. RESULTS AND CONCLUSION: The half lethal dose of [Fe(5-Fu)2(Phen)SO4] was 103.9 mg/kg. Compared with the negative control group, high dose group, positive control group and 5-fluorouracil could significantly inhibit the growth of the tumor (P< 0.05 orP< 0.01), and the effect of high dose group was the most obvious (P < 0.01). Compared with cisplatin, 60mg/kg [Fe(5-Fu)2(Phen)SO4] had a weaker inhibitory effect on the kidney, but higher inhibitory effect on the liver, spleen and thymus, indicating the complex has a lower nephrotoxicity, but stronger immunotoxicity and hepatotoxicity than cisplatin.

BACKGROUND:Anticancer drug and organic metal complexes wil form a new structure or a change in ion concentration, thus changing both the activity and toxicity to produce a synergistic effect. OBJECTIVE:To synthesize new high-efficient and low-toxic metal-fluorouracil complexes as anticancer drugs. METHODS:Copper, zinc and iron salts and fluorouracil were used to synthesize four copper, zinc and iron-fluorouracil complexes that were [Cu(5-Fu)2Cl2], [Cu(5-Fu)2(NO3)2], [Fe(5-Fu)3]SO4 and [Zn(5-Fu)2Cl2]. Preliminary chemical structures of the four complexes were confirmed by elemental analysis and mass spectrometry. Their inhibitory activity on human cancer cells, human leukemia cellline K562 and human colon cancer cellline HCT-116, was measured by MTT colorimetric assay. RESULTS AND CONCLUSION:[Cu(5-Fu)2Cl2], [Cu(5-Fu)2(NO3)2], [Zn(5-Fu)2Cl2] and [Fe(5-Fu)3SO4] were successful y synthesized. These four complexes at a mass concentration of 0.1-100 mg/L inhibited the proliferation of K562 and HCT-116 to different extents. The IC 50 values of these four complexes on K562 and HCT-116 cells were lower than those of fluorouracil, and their cytotoxicity was 1.5-7.8 times higher than that of fluorouracil. To conclude, copper/iron/zinc-fluorouracil complexes exhibit synergic inhibitory effects on cancer cellproliferation.

OBJECTIVESTo study the morphological feature of complicated thoracolumbar fractures and the fixation technology of injured vertebra.

METHODSFrom January 2005 to December 2007, 61 patients with type B and C thoracolumbar fractures according to AO classification were treated. There were 53 males and 8 females, with a mean age of 33.2 years (range, 9 to 65 years). Based on ASIA grading system of neurologic deficit, Grade A was found in 41 cases, grade B in 5 cases, Grade C in 5 cases, Grade D in 6 cases and Grade E in 4 cases. The injured vertebra located at thoracic region in 13, thoracolumbar in 39 and lumbar in 9 cases. The patients were divided into two groups: 32 cases with pedicle screws in the injured vertebra and 29 cases without pedicle screw in the injured vertebra. The analyses on the morphological features of injured vertebra were performed, and comparisons were carried out on the outcome regarding the reduction and correction of the injured vertebra, and the difference of Denis scale in pain domain and work status domain, between the two groups.

RESULTSAll the patients were followed up for an average of 3 years (range, 1.5 to 4.5 years). There were significance statistical difference in the correction loss of Cobb angle, sagittal index, correction of dislocation index, and the Denis pain scale between the two groups (P < 0.05). A better outcome was observed in the injured vertebra fixation group than the injured vertebra non-fixation group.

CONCLUSIONSInserting pedicle screws in the injured vertebra is effective and useful in the correction of complicated thoracolumbar fractures. It improves biomechanical stability of the spine after the operation.

Adolescent ; Adult ; Aged ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome ; Young Adult

OBJECTIVETo summarize application of rafting K-wires technique for tibial plateau fractures.

METHODSFrom January 2013 to January 2015,45 patients with tibial plateau fractures were treated by locking plate with rafting K-wires, including 33 males and 12 females with an average of 44.2 years old ranging from 22 to 56 years old. According to Schatzker classification, 6 cases were type II, 8 were type Ill, 4 were type IV, 4 were type V, and 5 were type VI. Allogeneic bone graft were performed for bone defects. All patients were fixed with two to five K-wires. Part of weight loading were encouraged at 3 months after operation,and full weight-loading were done at 5 months after operation. Postoperative complications were observed,and Rasmussen clinical and radiological assessment were used to evaluate clinical results.

RESULTSAll Patients were followed up from 10 to 23 months with average of 14 months. According to Rasmussen clinical and radiological assessment, clinical scores 23.58 ± 6.33, radiological scores were 14.00 ± 6.33; and excellent and good rates were 82.2% and 77.8% respectively. Four patients occurred severe osteoporosis and collapse of articular surface; 5 patients occurred traumatic arthritis.

CONCLUSIONRafting K-wires technique with anatomized armor plate could effective fix and support platform collapse and joint bone fragments, increase support surface area and reduce postoperative reduction loss rate.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery