Cluster Analysis ; Fuzzy Logic ; Humans ; Mathematics ; Medicine, Chinese Traditional

Objective To investigate the clinical manifestations of cytomegalovirus (CMV) infection in patients with systemic lupus erythematosus (SLE). Methods Data of the consecutive cases of SLE complicated with active CMV infection including clinical manifestations, SLEDAI score, dosage of corticosteroid and immunosuppressants used for treatment,radiological and laboratory examinations were collected and analyzed.Results Among 2221 consecutive patients of SLE, 5.4%(121 cases) were diagnosed to be complicated with active CMV infection. Fever was the most common symptom, followed by serious liver function damage,respiratory symptoms,hematological abnormalities, myocarditis, and encephalopathy, accounted for 81%(98cases), 6.6%(8 cases), 4.1%(5 cases), 3.3%(4 cases), 0.8%(1 case), and 0.8%(1 case)respectively; in addition, 22 (18.2%) cases had no symptom. SLEDAI was higher than 15 in 47.1% cases, and 10-14 in 28.1% cases. 81% of patients were treated with corticosteroid, and 55.4% were treated with immunosuppressants. Ganciclovir was given once the diagnosis of active CMV infection was established. In most of the patients, active CMV infection had been controlled within 14-28 days, except 4 died and 6 gave up the therapy. Conclusion SLE with active CMV infection is common,especially in patients who are treated with corticosteroid and/or immunosuppressants. Clinical manifestations of SLE complicated with active CMV infection are generally nonspecific.In patients with unexplained fever,or liver damage,or lung disease,or active SLE patients who have no symptom but are refractory to the treatment, CMV infection should be suspected and the relevant laboratory tests should be ordered for early diagnosis and treatment.

Epigenetics, which is called second genetic code precisely and controls the total metabolic processes of eukaryotic cells,has an inseparable correlation with human health and diseases. Among all the gene silencing mechanisms of epigenetic modifications,CpG islands of DNA promoter hypermethylation/histone mod-ifications are two major causes. Promoter methylation of specific genes,such as Ras protein activator analogue 1 may lead to aberrant activation of downstream signaling pathways,following by fibroblasts proliferation and kid-ney fibrosis. In recent years,epigenetic modifications have been proved to play a major role in preventing fibro-blasts to return to their quiescent stage,ultimately contributing to fibrosis in the kidney. This paper provides a glimpse of recent studies on epigenetic mechanisms of chronic kidney diseases,especially renal fibrosis,with an aim to provide new insights into pathogenesis research and clinical diagnosis and treatment.

Objective To study the relationship between the constant work rate exercises and dynamic hyperinflation in patients with stable COPD. Methods Routine lung ventilation function and 80%Wmax constant power bicycle ergometer exercises were tested in 30 stable COPD patients. We analyzed the correlation coefficient of Time of tolerant exercise , degree of dyspnea , VO2 max%, VO2 @kgmax% and IC%. Results All COPD patients existed varying degrees of exercise capacity accompaning with dynamic hyperinflation in the bicycle ergometer exercises. By Spearman correlation analysis , the VO2 @kg% of constant power exercises in patients with COPD is correlated with the DH% (r = -0.480, P = 0.007) and ICq% (r = 0.667, P = 0.01). Conclusion Dynamic hyperinflation is probably the prominent factors for the capability of constant work rate exercises in patients with stable COPD. Inhibition of dynamic hyperinflation may help improve exercise capability in patients with constant power exercise.

Objective To investigate the epidemiological and clinical characteristics of human coronovirus (HCoV ) infection in hospitalized children with acute lower respiratory tract infection (ALRTI)in Shanghai.Methods A retrospective cohort study was conducted between October 2009 and September 2012.Five hundred and fifty-four cases of ALRTI in children under 5 years were enrolled. HCoV and other respiratory viruses in archival nasopharyngeal aspirate specimens were detected by a commercial Seeplex RV12 ACE detection kit.HCoV pan-family reverse transcription polymerase chain reaction (PCR)was performed to screen all known six HCoV,including HCoV-229E,HCoV-OC43, severe acute respiratory syndrome (SARS)-CoV,HCoV-NL63,HCoV-HKU1 ,and real-time PCR was performed to screen Middle East respiratory syndrome (MERS)-CoV.MEGA5 .0 software was used to perform sequence alignment and phylogenetic tree analysis.Results In 554 samples,at least one virus was identified in 273 cases (48.56%)and HCoV was detected in 18 cases (3.25 %),among which 13 were HCoV-OC43/HKU1 positive,5 HCoV-229E/NL63 positive.No high pathogenic MERS-CoV and SARS-CoV were detected.The median age of 18 children with HCoV infection was 18 months (1 -48 months)with 12 boys and 6 girls.Seventeen cases had fever,11 cough,9 tachypenea and 1 wheeze. Seven received oxygen therapy,and 6 were admitted to intensive care unit for treatment.Two who was in ordinary ward were coinfected with adenovirus and human rhinovirus.All 18 cases recovered or improved on discharge.Six was infected in autumn,5 in winter,3 in spring and 4 in summer.Of 8 HCoV-positive samples which were sequenced,each 3 samples belonged to HKU1 and 229E subtypes,respectively,and each 1 belonged to OC43 and NL63 subtypes,respectively.Conclusions HCoV is a relatively common viral pathogen among hospitalized young children with ALRTI in Shanghai.No high pathogenic MERS-CoV is detected.HCoV can cause severe infection with favorable outcome.

Fundus photograph,angiography,optical coherence tomography,ultrasonography and other image technology and visual electrophysiology can provide a wealth of information for the diagnosis and treatment of pediatric retinal diseases.However,it put forward higher requirements on pediatric retinal imaging equipment and techniques which will be quite different from adult,because of pediatric retinal disease has its own characteristics,such as disease spectrum,pathogenesis,and pathophysiology.The principles and methods of image results interpretation on adult were not quite ready for children.It is necessary to further study the fundus imaging techniques suitable for children,gradually establish standardized examination procedures and clinical interpretation system,to promote the diagnosis of retinopathy in children.

To investigate the effects of cardiopulmonary bypass (CPB)on the aquired platelet damage and the relationship between the aquired platelet damage and non-surgical postoperative bleeding. Method: Platelet counts (BPC), alphagranule membrane protein (GMP-140), ?-thromboglobulin (?-TG), platelet factor 4 (PF_4), and 5-hydrooxytryptamine levels were measured in 20 patients undergoing cardiac surgery before CPB, 30 min during CPB, 10 min after CPB, and 2, 12, and 24 hours postoperatively. The numbers of patients with bleeding volume over 200 ml within 24 hours postoperatively were counted. Result: BPC decreased markedly during CPB, but never decreased to the degree of 50?10~9/L. GMP-140, ?-TG, PF_4 and 5-HT levels were significantly increased during CPB until 12 hours postoperatively. Eight patients(40%) got the bleeding volume over 200 ml within 24 hours postoperatively. Conclusion: Platelet release reaction is violent during cardiac surgery with CPB. A large number of platelets dysfunctioned because of granula releasing or damage may be the main cause of non-surgical postoperative bleeding.

Objective:Correlated factors of CET-4 scores and its washback effect on college English teaching were studied.Methods: more or less 1000 medical students′ CET-4 scores and their CET test anxiety levels were analyzed with SPSS 13.0 and Excel software.Result: It was shown that medical students′ CET-4 scores are negatively correlated with their CET-4 test anxiety levels,and positively correlated with the English scores in College Entrance Examination with significance,also correlated with their genders,their graduating senior high schools,their parents′ educational background,and without correlation with their majors.Conclusion: The positive effect of CET-4 washback can be applied to improve college English teaching quality and the aptitude of English language learning among medical college students.

Laboratory animal science, as a supporting discipline in life science research, has been set up courses in many universities, especially in medical schools.However, due to the curriculum design was too rigidly attached to tradition, emphasis on theory and cannot adapt to the development of natural science.In this paper, aiming to enhance the teaching effect, we focus on the practice, advance with the times, combine with customized teaching reform of laboratory animal science curriculum, teaching content and teaching forms.