Objective To reveal the relationship between the 5-HTTLPR and the Chinese Han nationality children with CA, compared the distribution of the 5-HTTLPR between the Han Chinese children with CA and healthy Han Chinese children ,and analyzed the association between the 5-HTTLPR and clinical symptoms of the Han Chinese children with CA. Methods Genomic DNAs of fifty subjects including 25 autistic children and 25 controls were extracted from blood samples. PCR amplification using Oligonucleotide primers flanking 5-HTTLPR was performed. Results ① Three kinds of alleles including the S (short) allele, the L (long) allele and the VL allele were found , and the 5-HTTLPR genotypes shown were S/S, L/L, S/L and L/VL. ② Allele frequencies did not differ significantly in patient groups in comparison with the control sample. No significant difference was identified between the observed 5-HTTLPR genotype distribution of the patient groups and control group. ③ The distribution of homozygous and heterozygous subjects between the two groups differed significantly. ④ The genotypes of the 5-HTTLPR polymorphism correlated significantly with the Body Movement Factor. ⑤ The allele frequency of healthy Han Chinese population and that of healthy Japanese population were similar. The frequency of S allele in not only autistic subjects but also healthy children in this study was considerably more than that in Caucasians and the frequency of L allele in our subjects decreased correspondingly. Conclusion ① A significant difference in the allele frequency between the Han Chinese and Caucasian populations was found. ② The genotypes of the 5-HTTLPR polymorphism correlated significantly with the Body Movement Factor of the patients. ③ The homozygote and the L allele were positively relevant to CA and they might be the risk factors of CA. The heterozygote and the S allele were negatively relevant to CA and they might be the protective factors of CA.

Objective To investigate the effects of Compound Zhe Bei granule (CZBG) combined with doxorubicin on the expression of GST and Topo - Ⅱ in K562/A02 cell line multidrug resistance tumor xenografts in mice. Methods Tumor xenografts model was established by injecting the multidrug resistance cell line K562/A02 in the axillary flank of BALB/c - nu - nu mice. Drug - comgbination of CZBG intragastric administration and doxorubicin intraperitoneal injection ( i. p. ) was given to the BALB/c - nu nude mice. The tumor xenografts were made into slice after the dissection, and the expression of GST and Topo - Ⅱ in K562/A02 tumor xenografts in mice was investigated by immunohistochemical technique. The integral optical density (IOD) of GST and Topo- lⅡ in K562/A02 tumor xenografts was measured by Image ProPlus 6.0. Results Compared with the single treatment of doxorubicin i. p group,the combination of the doxorubicin and CZBG with dosage classified by three types( high, middle, low) can decrease IOD of GSH and Topo - Ⅱ in K562/A02 tumor xenografts with statistical significance( P

Objective To evaluate the efficacy of topical anesthesia with inhaled aerosolized lidocaine during tracheal intubation under the guidance of fiberoptic bronchoscopy (FOB) in patients with cervical cord injury complicated with high paraplegia. Methods Sixty-four patients with cervical cord injury complicated with high paraplegia were randomly divided into 2 groups ( n = 32 each): group Ⅰ aerosol inhalation and group Ⅱ spray and cricothyroid membrane puncture. In group Ⅰ aerosolized 2% lidocaine was inhaled. In group Ⅱ after the pharynx and larynx was sprayed with 2% lidocaine, cricothyroid membrane puncture was performed and then 2% lidocaine 2 ml was injected. Midazolam 0.01 mg/kg and fentanyl 1 μg/kg were injected iv in both groups 15 min before tracheal intubation guided by FOB. During tracheal intubation guided by FOB, the intubation condition was assessed, and MAP, HR, ECG and SpO2 were monitored. Results The satisfactory rate of intubation condition and success rate of intubation under the guidance of FOB were significantly higher, and the incidences of arrhythmia and bad memory lower in group Ⅰ than in group Ⅱ ( P ＜ 0.05). Conclusion The topical anesthesia with inhaled aerosolized 2% lidocaine is helpful for improving the FOB-guided tracheal intubation condition, and can reduce the occurrence of adverse effects in patients with cervical cord injury complicated with high paraplegia.

Objective To test using musculoskeletal ultrasound (MSUS) to observe uncovertebral joints (UJs) and to explain the ultrasound images of UJs and their adjacent tissues,especially the vertebral artery (VA).Methods MSUS was used first with human skeletons and cadavers to localize the UJs and VA on the MSUS images with the aid of implanted needles.MSUS was then used with a patient clinically diagnosed with cervical spondylosis of the vertebral artery type (CSA) to detail the image of a normal UJ and its relationship with the adjacent tissues,especially the VA.Whether there was a lateral spur from the uncinate process (UP) was assessed to try to establish a method for measuring osteophytes.Results During the examination the patient was in supine,the neck was elevated 15cm with a pillow and was at 45 degrees of rotation to the contralateral side.The probe was placed at the medial border of the sternocleidomastoid muscle.When the longitudinal section of the common carotid artery was shown,the probe was slowly moved laterally until the VA first appeared,and then was moved up along the VA.Once the VA entered the transverse foramen,moving the probe slightly allowed the UJ behind the VA to be seen between two transverse processes.The UJ thus lies between two transverse processes,that is,between the lateral margins of two vertebral bodies and outside the intervertebral disc.The echo of the lateral border of the UP is on a straight line with the echo of the lateral margin of the vertebral body,with the VA in front of the line.It was noticed that the image of a UP with lateral osteophyte formation crossed the line and reached closer to the VA.The transverse diameter of the UJ was measured as the distance from a line cutting the lateral cortical margin of the cervical vertebra to the outer cortical margin of the lateral UP.Conclusion MSUS can clearly show the UJ and its adjacent tissues,especially the VA.It can be used to assess and measure UJs with lateral osteophyte formation.

Objective To evaluate the clinical value of radionuclide pulmonary perfusion imaging in diagnosing acute pulmonary embolism.Methods Radioactive pulmonary perfusion imaging was performed in 25 patients clinically suspected for acute pulmonary embolism,meanwhile,imaging of deep veins of lower limb was taken.Results Multiple segments of abnormal blood perfusion were found in 23 of 25 patients,among them,radioactivity defects were found in 41 segments,radioactivity rarefied areas were found in 84 segments.Deep venous thrombosis was detected in 6 patients.Conclusion Radionuclide pulmonary perfusion imaging is a non-invasive and effective method in diagnosing acute pulmonary embolism.

Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups (n =20 each) using a random number table:spinal anesthesia group (group S) and lumbar plexus block group (group L).In group S,0.5 ％ hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 ％ ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.

Objective To evaluate the therapeutic effect and safety of the rituximab in the treatment of severe rheumatoid arthritis (RA). Methods A total 22 severe RA patients with DAS28＞5.1 were treated with rituximab 500～1000 mg/24week, or placebo/24 week, along with methotrexate (MTX) 10～25 mg/week.Chi-square test was adapted for statistical analysis if the results met the data criteria for the analysis. Rank conversion analysis was used to test the results if the data did not satisfy the Chi-square test. Results Twenty-two patients (93% were females with the median age of 50 yd and the average MTX dosage was 17.6 mg/week ) completed the treatment. The proportion of ACR 20 responders at 72 week was 80%, 60%,57% respectively. Other secondary efficacy endpoints showed that rituximab could provide substantial benefits to patients with RA by reducing clinical signs and disease activity score. The most frequently occurred adverse event was upper respiratory tract infection. Tne second most frequent adverse events were reduction of lymphocytes and elevation of liver enzymes. Most treatment-related adverse events were mild to moderate in severity. Conclusion Rituximab has demonstrated to be effective and is well tolerated by patients in the treatment of active RA.

Objective To evaluate the effect of red yeast rice on chemokines of collagen-induced arthritis in rats. Methods Rat arthritis was induced by injecting bovine type Ⅱ collagen(BⅡC)to Wistar rats.The rats were randomly divided into six groups including the normal control group,the CIA control group which were treated with normal saline,ibuprofen group,large dose red yeast rice group,moderate dose of red yeast rice group and small dose of red yeast rice group.Mice were sacrificed after 48 days of immune injection and their venous blood were collected. The effect of cytokines and chemokinos on CIA was measured by ELISA.Results Red yeast rice significantly degraded the expression of TNF-α,IL-6 compared with the model groups,the difference was significantly different(P＜0.05).The degree of IL-8 decrease was more evident in the high dose of Red yeast rice group and moderate dose of Red yeast rice group than that of the model group(P＜0.05).Red yeast rice could significantly degrad the expression of MCP-1,R.ANTES and IP10 in serum of CIA rats(P＜0.05).Conclusion The mechanism of anti-inflammatory action of red yeast rice is related to the inhibition of inflammatory factors.

Objective:To analyze clinical characteristics of cutaneous delayed-type hypersensitivity caused by injection of equine tetanus antitoxin (TAT) or equine anti-tetanus immunoglobulin F (ab′) 2. Methods:Clinical data were collected from 181 outpatients or inpatients with cutaneous delayed-type hypersensitivity caused by injection of equine TAT or anti-tetanus immunoglobulin from 2008 to 2020, and retrospectively analyzed.Results:Before the injection of equine TAT or anti-tetanus immunoglobulin, skin test was negative in 171 (94.47%) of the 181 patients, and the 10 (5.53%) patients with positive skin test responses received desensitization injection. Among the 181 patients, there were 118 males and 63 females aged from 11 to 68 years, with the disease duration of 1 to 7 days and alatency period of 4 to 14 days. There was no significant difference in the clinical manifestations between the patients receiving injection of TAT (130 cases) and those receiving injection of equine anti-tetanus immunoglobulin (51 cases) . Urticaria-like rashes were the main clinical manifestation, and infiltrative erythema occurred at the injection site in 12 patients, of whom 10 developed generalized urticaria all over the body. Of the 181 patients, 163 (90.06%) presented with generalized skin rashes, and 56 (30.94%) had systemic symptoms such as chest tightness, fever, etc, of whom 15 (26.79%) had a history of allergies and 6 with severe symptoms had no history of allergies. Thirty-four (18.78%) patients had single or multiple laboratory abnormalities, such as increased white blood cell counts, elevated C-reactive protein level and urinary glucose, and presence of occult blood in urine. All cases responded well to the treatment with antihistamines and glucocorticoids. The treatment duration ranged from 3 to 10 days, and the outcome was good.Conclusion:TAT-or anti-tetanus immunoglobulin-induced cutaneous delayed-type hypersensitivity may still occur in patients with a negative skin test or after desensitization treatment, and mainly manifests as urticaria-like rashes.

ObjectiveTo evaluate the efficacy and safety of etanercept 50 mg once-weekly treatment of Chinese patients with active ankylosing spondylitis ( AS).Methods Four hundred patients with active AS,enrolled in six medical centers,were randomly divided into either the treatment group or the placebo group in a 3∶1 ratio.The total length of the study was 12 weeks.The first 6-week period was a double-blind placebo controlled treatment period and the second 6-week period was an open-labeled treatment period.During the first 6-week period,300 patients in the treatment group received once-weekly subcutaneous injection of etanercept (50 mg),whereas the 100 patients in the placebo group received placebo injection.During the second 6-week period,patients in both groups received etanercept (50 mg once weekly subcutaneous injection).The primary end point was the percentage of patients achieving the Assessments in Ankylosing Spondylitis (ASAS) 20％ response ( ASAS 20 ) at week 6.Other outcome measures included the percentage of patients achieving ASAS 5/6,partial remission and Bath AS disease activity index 50 ( BASDAI 50) responses at week 12.ResultsA total of 381 patients completed the trial,including 285 patients in the etanercept group and 96 patients in the placebo group.At week 2,the percentage of patients achieving ASAS 20 in the etanercept group was 55.7％,whereas the placebo group was only 17.0％ ( P ＜ 0.001 ).At week 6,77.5％ of patients in the etanercept group achieved ASAS 20 as compared with 32.3％ in the placebo group ( P ＜ 0.001 ).At the end of 12 weeks,the percentage of patients in the etanercept group achieving the ASAS 20 was 89.5％.Improvements of other measures were also significant in the etanercept group.Etanercept was well tolerated and no malignancy and life-threatening events were observed in this study.Most adverse events observed were mild injection-site reactions.ConclusionEtanercept 50 mg weekly treatment of Chinese patients with active ankylosing spondylitis is convenient,fast-acting,highly effective,and well tolerated.