Child ; Guidelines as Topic ; Humans ; Pneumonia, Pneumocystis ; diagnosis ; therapy

[Objective] To investigate the change of liver histology, proliferation of BDEC, and expression of TGF-β in different stages of liver chelestusis. [Methods] ①Rat cholestatic livers were induced by common bile duct ligation (BDL) and separated into 3 groups, namely control group (DO), 7 days after BDL group (DT), and 18 days after BDL group (D18). ② Histological changes of livers in different groups were evaluated based on Knodell HAI score. ③ Real-time PCR was used to detect the expression of TGF-β in liver tissue and isolated BDEC in different groups. ④ Statistically analyzing the correlation between Knedell HAl score and the levels of TGF-β_1 mRNA. ⑤ In vitro study was performed to investigate the effect of TGF-β_1 on an immortalized mouse intrahepatic bililary epithelial cell line (mIBEC). [Results] (I) Knedell HAI score and the proliferation of intrahepatic bile ducts increased as the liver cholestasis aggravated. ② The levels of TGF-β_1, TGF-β_2, and TGF-β_3 mRNA were significantly up-regulated in liver tissues and BDEC as the liver cholestasis aggravated. ③ Positive correlation was found between Knedell fibrotic score and the levels of TGF-β_1 mRNA in liver tissues and BDEC(r=0.9376, P<0.05 and r=0.9682, P < 0.01). ④ In vitro study showed that TGF-β_1 inhibited the proliferation of mIBEC. [Conclusion] ① Liver injury, biliary proliferation, and the levels of TGF-β mRNA expression increased as liver cholestasis aggravated. ② The interaction of TGF-β_1 and BDEC plays an important role in the pathogenesis of BDL induced cholestatic liver disease. ④ Up-regulated expression of TGF-β_1 mRNA in the proliferated BDEC participates in the formation of BDL induced cholestatic liver fibrosis.

Objective To study the simple preparation method and structure of nano-hydroxyapatite/collagen composite, to investigate new substitute of repairing bone for using in tissue engineering. Methods Porous nano-hydroxyapatite was made of Ca (OH)2 and H3PO4. Collagen was drawn from fresh adult bovine tendon. The two materials were prepared into biomembrane through the glutaraldehyde and freeze-drying. The crystallite phase, micro-morphology, structure, crystallite size of the composite were examined by XRD and scanning electronic microscop (SEM). Results The results showed that the composite structure was porous and consisted of nano-hydroxyapatite (10 nm ? 50 nm - 20 nm ? 80 nm) and collagen fiber. The crystallite phases and size of the composite was similar to that of natural bone. Conclusion The porous nano-hydroxyapatite /collagen composite is expected to be an ideal substitute of repairing bone.

Collagen fibrils and hydroxyapatite might recognize each other at the mesoscale by multiple cooperative interactions due to their intrinsically repetitive structured surfaces, and thus effectively directing the biomineralization, a biological process involving regulating the growth of bones, teeth and other organs. In this work, we developed a simple technique to prepare nanowire arrays of biological macromolecules by reversely using the biomineralization mechanism, with results similar to the hot wall epitaxy, a molecular beam deposition technique under vacuum. With this technique, we successfully cultured 5-10 μg/mL rat tail type I collagen monomer solutions into collagen nanowire arrays on the mica (001) lattice plane along one unique direction across the whole cleavage surface. The atomic force microscope experiments indicated that the nanowires in the arrays became more crowded with higher monomer concentration, but their width and height remained unchanged, about 60.0 nm and 1.5 nm, respectively. The collagen nanowire coating enhanced the hydrophilicity of the mica surface, reducing the contact angle from 25.8° to 9.5°. Based on the characterization results of electron back scattering diffraction and transmission electron microscope, the collagen nanowires were most likely to be oriented along the mica [110] direction, which validated the quasiepitaxial growth mechanism in more details.

ObjectiveTo investigate the clinical efficacy of Jin’s eye three-needle acupuncture as main therapy for acquired paralytic strabismus.MethodSeventy patients with acquired paralytic strabismus were randomly allocated to acupuncture and Western medication groups. Both groups of enrolled patients took prednisone,methycobal, vitamin B1and vitamin B12. In addition, theacupuncture group received Jin’s eye three-needle acupuncture as main therapy. The clinical therapeutic effects and adverse reactions were observed after four and eight weeks of treatment.ResultThe total efficacy rate was 75.0% in the acupuncture group and 51.6% in the Western medication group after four weeks of treatment and 90.6% in the acupuncture group and 77.4% in the Western medication group after eight weeks of treatment. There were statistically significant differences between the two groups (P<0.05). Patients in the acupuncture group occasionally had acupuncture syncope and local blood stasis. Both groups had no special discomforts.ConclusionJin’s eye three-needle acupuncture has a quick and definite therapeutic effect on acquired paralytic strabismus.

Altitude ; Animals ; Arvicolinae ; Gene Expression ; Hypoxia ; Rats ; Tumor Suppressor Protein p53 ; genetics

12 strains of H2-producing bacteria were isolated and purified from anaerobic sludge, aerobic sludge and river bottom sludge by Hungate method. A new species of high efficient hydrogen production bacterium Enterococcus sp. LG1 (registration number: EU258743 ) was studied deeply. It was showed that the Enterococcus sp. LG1 was an anaerobic and Gram-negative bacterium. Sequence analysis of this type of clones showed that it was affiliated with the genus Enterococcus and it was not reported yet in other paper at present. Meanwhile, batch tests of anaerobic fermentative hydrogen production by Enterococcus sp. LG1 were investigated by using sterilization pretreated sludge as substrate. The changes of soluble COD, protein, carbohydrate and pH value during hydrogen fermentation were monitored. It was found that only hydrogen and carbon dioxide were produced by this strain and no methane was detected during fermentation. The maximal hydrogen yield was 36.48 mL/g TCOD and the hydrogen concentration in the gas phase was 73.5%. The Enterococcus sp. LG1 was a butyrate fermentation bacteria analyzed by metabolites.

Objective To explore the effects of action observation therapy on upper-extremity motor function and ability in the activities of daily living after cerebral infarction.Methods Forty-one cerebral infarction survivors were randomly assigned to an observation group (n =21) or a control group (n =20).Both groups were given the conventional rehabilitation treatment,while the observation group additionally received action observation therapy 20 mins per day,6 times per week for 8 weeks.Before and after the 8 weeks of treatment,both groups were assessed using the Fugl-Meyer assessment (FMA),Wolf's motor function test (WMFT) and the modified Barthel index (MBI).Results Before the intervention there was no significant difference between the groups in any of the measurements.After the 8 weeks of treatment,all of the results in the treatment group were significantly better,on average,than those of the control group.Conclusions Action observation therapy can improve upper-extremity motor function and ability in the activities of daily living after stroke.

Objective To review the clinical features , diagnosis , prognosis and treatment of polycythemia vera ( PV) complicated with acute coronary syndrome ( ACS) .Methods The clinical data of 2 PV patients complicated with ACS admitted to Peking Union Medical College Hospital ( PUMCH ) were retrospectively analyzed and the recent literatures were reviewed .Results Case 1 was a 65-year old man who had been diagnosed PV with a positive JAK2V617F mutation 3 years ago.At presentation, the patient was suffering from recurrent angina pectoris , and coronary angiography revealed that there was a severe ( 80%) stenosis in the middle segment of left circumflex and a Xience V stent was implanted .After the percutaneous transluminal coronary intervention ( PCI ) , secondary prevention for coronary heart disease and hydroxyurea for PV were given and the patient has been followed up regularly for more than three years and he is going well.Case 2 is a 44-year old man who was diagnosed PV with a positive JAK 2 mutation 3 years ago and hydroxyurea, interferon, aspirin was prescribed.Then splenic infarction, thrombosis of splenic vein,regional portal hypertension , severe varices of fundus of stomach and upper gastrointestinal bleeding developed with him.Two months ago , an AMI of inferior wall occurred and the angiographic findings demonstrated an thrombotic lesion in the proximal segment of the right coronary artery with a moderate stenosis ( 60%);1 month ago an AMI of anterior wall developed and coronary angiography discovered that there were diffuse thrombus in the proximal segment of left anterior descending artery with a severe stenosis ( 90%) and a complete occlusion in the right coronary artery .After double antiplatelet therapy with anticoagulation therapy of warfarin was given , the patient recovered gradually .Conclusions PV complicated with ACS is relatively rare.According to recent studies, positive JAK2V617F mutation, leukocytosis, age >65 years and positive history of thrombosis are the most important predictors of cardiovascular events .Clinicians should design individualized treatment strategies for patients on the basis of clinical features , coronary angiography findings and complications .For those with thrombotic lesion in the coronary artery due to the hypercoagulative state caused by PV, it should be cautious to carry out a coronary revascularization treatment .

Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 ％).The rates of drug combinations were statistically different but both were close to 75％ in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.