Child ; Female ; Humans ; Polyendocrinopathies, Autoimmune ; classification ; diagnosis ; therapy ; Treatment Outcome

Objective To evaluate the efficacy and safety of topiramate(TPM) as add - on drug treating infants with severe epilepsy. Methods We performed prospective label add - on study in 12 infants (aged 4 to 19 months) with sever seizures of different types. TPM was add - on one or more other baseline drugs and the efficacy was evaluated according to seizure type and frequency Results TPM initiated in a daily dose of 0.5 - 1 0 mg/kg, followed by a 1 - 2 weeks titration on the increase of 0 5 - 1.0 mg/kg up to a maximum daily dose of 4 - 10 mg/kg. After a mean period of 6 2 months (range 3- 13 montks), Total efficacy was 75 % and 50 % were controlled completely. Seizure frequency was unchanged in 3 patients (25 % ). As for seizure type, TPM was more effective in complex partial as compared with generalized tonic-conic seizures. Mild adverse events were present in 3 patients (25 %), represented hypersonia, fever and decreased speech. Conclusions TPM may be a available drug in infants with severe epilepsy. It is safe, with mild adverse effect in fewer patients.JAppl Clin Pediatr,2004,19(11):986-987

OBJECTIVETo investigate the predictive value of HCV RNA in PBMC of patients with chronic hepatitis C to IFN treatment.

METHODSThe HCV RNAs in PBMC were detected at the end of treatment, and 24 week and 1 year follow up after end treatment, in 16 patients who acquired complete response to IFN in 12 weeks of 24 weeks therapy.

RESULTS9 patients were HCV RNA positive in their PBMC at the end of treatment, the serum HCV RNA of 8 turned positive after 24 weeks and 1 year follow-up. In 7 patients with negative HCV RNA in PBMC, only two patients relapsed in serum HCV RNA after 1 year follow-up, and others remained viral response after 3.5 years.

CONCLUSIONHCV RNA in PBMC at the end of treatment was a predictor of the durable response to antiviral therapy in chronic hepatitis C.

Adult ; Female ; Hepatitis C, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Leukocytes, Mononuclear ; virology ; Male ; Middle Aged ; RNA, Viral ; blood ; Recombinant Proteins

Objective To explore the prevalence of self reposed mania/hypomania symptoms of depressive disorders and the difference between the two self-rating symptoms questionnaires in setting of psychiatric clinic of a general hospital.Methods 102 outpatients who were diagnosed with depressive disorders by ICD-10 in department of psychiatry of Tongji Hospital of Tongji University were continuously investigated and fulfilled the Chinese Version mood disorder questionnaire(CV-MDQ)and the Chinese Version 32 items hypomania check list(CVHCL-32).The positive mania symptoms were elevated with at least seven positive mania items reported by the CVMDQ.The positive hypomania symptoms were elevated with at least fourteen positive hypomania items reported by the CV-HCL-32.Results The internal consistency(Cronbach alpha)of the CV-MDQ was 0.808(95% CI=0.767～0.845,P<0.01).The internal consistency(Cmnbach alpha) of the CV-HCL-32 was 0.916(95% CI=0.898～0.930,P<0.01).11 patients(10.8%) reported positive mania symptoms by the CV-MDQ.14 patients (13.7%)had been reported positive hypomania symptoms through the CV-HCL-32.The ability of discriminating mania or hypomania between the two scales was significantly different(Kappa=0.227,P<0.05).Compared to the patients who were reported negative hypomania symptoms by the CV-HCL-32.the 11 patients with positive hypomania symptoms by the CV-HCL-32 had much earlier age in first episode(35.0 vs 50.5,z=-2.065,P<0.05),much longer months in total disease course(60.0 vs 22.0,z=-2.102,P<0.05)and present episode (12.0 vs 6.0,z=-2.180,P<0.05),and much higher frequency of relapse(2.5 vs 1.0,z=-2.168,P<0.05),but no significant differences at age,gender and education.No significant differences appeared between CV-MDQ positive and negative group.Conclusion Mania or hypomania symptoms may be screened by CV-MDQ and CV-HCL-32 from the outpatients with depressive disorders who are diagnosed by ICD-10 in general hospital.whether CV-HCL-32 is superior to CV-MDQ when screening bipolar Ⅱ disorder is worthly further study.

This paper deals with research and manufacture processes of the 8 millimeter wave therapeu- tic apparatus,the application to the clinical treatment for gastric and duodenal ulcer.

OBJECTIVETo discuss the clinical effects of using rotating hinge prosthesis in treating primary malignant tumor of the proximal tibia.

METHODSAfter the malignant tumor of the proximal tibia was extensively resected or radically resected, rotating hinge prosthesis replacement was performed for reconstruction, while neoadjuvant chemotherapy was used in treating the osteosarcoma.

RESULTSThe average follow-up period was 4.2 years. There was no local recurrence and metastasis in 22 patients, though there was recurrence in 8 patients. The MSTS functional scores of all different items 4 years after the operations were above 3, which showed the clinical results were satisfactory.

CONCLUSIONSIt is an efficacious method for the treatment of malignant tumor of the proximal tibia by using rotating hinge prosthesis. It has the advantage of early recovery of joint function.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Bone Neoplasms ; surgery ; therapy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Male ; Middle Aged ; Tibia ; surgery

Objective To examine the prevalence of depressive symptoms and related factors among HIV-positive men who have sex with men (MSM) in Shanghai.Methods All of the HIV-positive MSM were enrolled to participate in a cross-sectional study with questionnaire-based interview during Nov.,2014 to Nov.,2015.Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D),where a score of 9 had been recommended as the cutoff score to indicate possible depressive symptoms.Results A total of 505 participants were recruited with a median age of 30.Among them,the majority were aged 21-44 (77.2％),non-local resident (64.6％),unmarried (73.1 ％) and university graduate or above (62.1 ％).Depressive symptoms were detected from 235 MSM and the prevalence of depression was 46.5 ％.Multiple logistic regression analysis showed that MSM who were non-local residents (OR =1.66,95 ％ CI:1.01-2.49)and had more than one male sex partner in the past year (OR=2.21,95％ CI:1.43-3.41) were more likely to have depressive symptoms compared with local residents and had only one male sex partner or less.On the contrary,compared with the education level of junior middle school or below and having no long-term partners,those who were senior high school educated (OR=0.39,95％ CI:0.21-0.74) and had homosexual behavior with main long-term partners without condoms (OR =0.38,95 ％ CI:0.17-0.85) had lower risk to be depressive.Conelusions The prevalence of depressive symptoms among HIV-infected MSM is high.Residence,education level,homosexual behavior with main long-term partner and number of male sex partner are significantly associated with depressive symptoms,suggesting psychological interventions should be further explored and studied.

Objective: To investigate the relationship between P27，P53 and PCNA expression in human gastric carcinoma tissues and clinicopathological parameters. Methods: The expression of P27，P53 and PCNA in 62 human gastric carcinoma tissues was examined with immunohistochemistry SP method. Results: Positive rates of P27，P53 and PCNA expression were 37.1％, 40.4%，83.9％. P27 expression was related with Bormann type, infiltrative depth, lymph node and distant metastasis and clinical stage. P53 expression was related with sex of patients, distant metastasis and clinical stage. PCNA expression was related with age of patients and infiltrative depth of tumor. P27 positive expression group was higher than negative group as to 5-year survival. P27 expression was in reverse relation with PCNA expression. Conclusion: The expression of P27, P53 and PCNA may be regarded as an important marker in judging malignant degree of gastric carcinoma,distant metastasis and prognosis.

OBJECTIVETo introduce and evaluate the clinical effects of percutaneous reduction and Kirschner pin fixation for the treatment of intraarticular fractures of the calcaneus in children.

METHODSFrom March 2001 to February 2009,12 patients with intraarticular calcaneal fractures were treated by percutaneous reduction and Kirschner pin fixation (13 feet). There were 8 males and 4 females,ranging in age from 3 to 14,with an average of 8.7 years. According to Essex-Lopresti classification, among 5 feet were tongue fractures and 8 feet were compressed fractures. According to Sanders classification, 9 feet were type II and 4 feet were type III. The Biihler angle and Gissane angle of the calcaneus were obtained before and after operation. All patients were evaluated according to Maryland Foot Score.

RESULTSAll the patients were followed up for 16-71 months (means 35.9 months),and all the incisions were healed without complications and infection. The preoperative X-ray film showed that Böhler angle was (19.7+/-5.3) degrees, Gissane angle was (137.3+/-7.5) degrees. The postoperative X-ray film demonstrated that Böhler angle was (32.6+/-3.7) degrees, Gissane angle was (125.4+/-2.9) degrees. There was a significant difference between preoperative and postoperative (P<0.01). The average Maryland score was 96.3+/-2.4 (range, 92 to 100 points).

CONCLUSIONPercutaneous reduction and Kirschner pin fixation is an effective minimally invasive way to treat intraarticular fractures of the calcaneus in children, it has many advantages such as minimal invasion, reliable fixation and satisfactory effects.

Adolescent ; Bone Nails ; Calcaneus ; injuries ; surgery ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Intra-Articular Fractures ; surgery ; Male

BACKGROUNDHuman urotensin II (UII) is the most potent mammalian vasoconstrictor identified so far. Our previous study showed that UII is a potent mitogen of airway smooth muscle cells (ASMC) inducing ASMC proliferation in a dose-dependent manner. The signal transduction pathway of UII mitogenic effect remains to be clarified. This study was conducted to investigate the signal transduction pathway in the proliferation of ASMC induced by UII.

METHODSIn primary cultures of rat ASMCs, activities of protein kinase C (PKC), mitogen-activated protein kinase (MAPK) and calcineurin (CaN) induced by UII were measured. The effect of CaN on PKC and MAPK was studied by adding cyclosporin A (CsA), a specific inhibitor of CaN. Using H7 and PD98059, inhibitors of PKC and MAPK, respectively, to study the effect of PKC and MAPK on CaN. The cytosolic free calcium concentration induced by UII was measured using Fura-2/AM.

RESULTSUII 10(-7) mol/L stimulated ASMC PKC and MAPK activities by 44% and 24% (P < 0.01), respectively, after incubating for 20 minutes. It increased CaN activity in a time-dependent manner, being 1.68 times as that of control for 24 hours (P < 0.01). It promoted the cytosolic free calcium concentration increase of 18% (P < 0.01). CsA 10(-6) mol/L and H7 50 micromol/L inhibited UII-stimulated CaN activity by 45% (P < 0.01) and 21% (P < 0.05), respectively, while PD98059 50 micromol/L had no effect on CaN activity (P > 0.05). CsA 10(-6) mol/L inhibited UII-stimulated PKC activity by 14% (P < 0.05), while having no effect on MAPK activity (P > 0.05).

CONCLUSIONSUII increases cytosolic free calcium concentration and activates PKC, MAPK and CaN. The signal transduction pathway between PKC and CaN has cross-talk.

Animals ; Calcineurin ; metabolism ; Cells, Cultured ; Enzyme Activation ; Mitogen-Activated Protein Kinases ; metabolism ; Mitogens ; pharmacology ; Myocytes, Smooth Muscle ; cytology ; Protein Kinase C ; metabolism ; Rats ; Signal Transduction ; physiology ; Trachea ; cytology ; Urotensins ; pharmacology