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.

Despite detailed examinations have been performed,the etiology in about one third of ischemic strokes remain uncertain,which are called cryptogenic ischemic strokes.In the recent 2 decades,it has been found that patent foramen ovale(PFO)is closely associated with these cryptogenic strokes,and a roamber of profound studies have been performed subsequently,and a lot of new conceptions have been put forward.INs article reviews advances in research on the relationship between PFO and iscbemic stroke.influencing factors of PFO leading to ischemic stroke,as well as the diagnosis and treatment of PFO.

Objective:To analysis the clinical characteristics of pulmonary hypertension (PH) complicating pregnancy, then to explore the delivery time and the monitodng as well as the treatment during perinatal peri-od.Methods:The data of 10 cases with PH treated in our hospital from June 2005 to January 2009 were retro-spectively analyzed.Reaults:1 case was primary pulmonary hypertension(PPH) ; 9 cases were secondary PH (SPH), in which 4 cases were rheumatic heart disease and 5 cases were congenital heart diseases.3 cases were slight PH,6 cases were moderate PH, and 1 were severe group.4 cases NYHA class were Ⅰ～Ⅱ and 6 cases NYHA class were Ⅲ～Ⅳ.4 cases were term delivery,5 cases were premature delivery, and 1 got artifi-cial abortion.8 cases were cesarean section, and 1 was vaginal delivery.2 cases were very low birth weight infants, 1 infant was death and 1 mother was death.Conclusions:The patient of PPH should avoid concei-ving.For SPH patients whether to conceive depends on cardiac function, the level of pulmonary arterial pres-sure and should better get pregnancy after surgery or medication.It should terminate pregnancy in the first tri-mester for moderate or severe patients.Cesarean section is more suitable for those in the second or third tri-mester.The prognosis of the mother and neonate depends on several factors.

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.

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.

From 38 pieces of deep\|sea samples,a strain,DY\|A,which produces protease was isolated.It can grow at a wide range of pH and salt concentration and best at 10℃.The strain produced maximum protease activity after growth at 10℃,initial pH 10 0 and inoculation volume 0 5%for 48～72h on a shaker by speed of 200r/min.The optimum pH and temperature for the protease activity production are pH 10.0 and 40℃.The enzyme is alkaline protease.Some other properties of the strain and the protease were discussed in detail.

Arsenic is a common environmental toxin,but also a carcinogen.Long-term exposure to inorganic arsenic can cause multi-system and multi-organ damage in the body,including cancerous and non-cancerous lesions.As one of the main target organs of arsenic exposure,skin damage is of great significance for the diagnosis and health assessment of arsenic poisoning in population threatened by the disease.From the perspective of arsenic exposure and skin cancer,the aim of this article is to summarize the epidemiology,pathogenesis and medical intervention of arsenic-induced skin cancer,and to provide reference for the pathogenesis and prevention of endemic arsenic poisoning related skin diseases.