OBJECTIVETo establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

METHODSA Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.

RESULTSClustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).

CONCLUSIONThe establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

Alarmins ; Brain ; Cluster Analysis ; Diarrhea ; classification ; diagnosis ; Hot Temperature ; Humans ; Irritable Bowel Syndrome ; classification ; diagnosis ; Medicine, Chinese Traditional ; Qi ; Retrospective Studies ; Surveys and Questionnaires ; Yang Deficiency

Adult ; China ; epidemiology ; GB virus C ; classification ; Hepatitis, Viral, Human ; epidemiology ; virology ; Homosexuality, Male ; Humans ; Male

In the development of diabetic nephropathy (DN), reactive oxygen specie (ROS) over much in vivo leads to oxidative stress(OS)-related renal injuries, which are characterized by the structural and functional changes in glomerular and renal tubular cells in morphology. The regulative approaches of OS involve the several signaling pathways, in which, both p38 mitogen-activated protein kinase (MAPK) signaling pathway and adenosine monophosphate-activated protein kinase (AMPK) signaling pathway play the important roles as the target of anti-oxidants. The interventional actions of Chinese herbal compound prescriptions and the extracts of single Chinese herbal medicine (CHM) on OS in the kidney in DN include regulating the balance between ROS and antioxidants, reducing the production of AGEs, inhibiting the expression of growth factors and intervening the activity of signaling pathways.
Animals ; Diabetic Nephropathies ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Kidney ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Signal Transduction ; drug effects ; Treatment Outcome

Due to their good safety, wide application scope and quick onset time, lipid emulsions are full of promise to reverse drug poisoning. In this review, a number of clinical case reports were summarized to analyze the detoxification effect of lipid emulsions on local anesthetic, antiarrhythmic, psychotropic and organophosphate poisoning, as well as the possible adverse reactions of lipid emulsions therapy.Meanwhile, the mechanisms underlying lipid emulsions therapy, such as lipid sink theory, enhanced body basal metabolism and positively affected cardiovascular function, were fully interpreted.Besides, a few potential solutions to the problems still existing in lipid emulsions therapy were proposed, in order to consolidate the understanding of lipid emulsions therapy and promote its rational application in reversing drug poisoning.

Objective To investigate the protective effect of Astragalus on islet β cell apoptosis in vivo.Methods Fifty-six healthy male mice were divided into control group,diabetic mellitus (DM) group,and Astragalus pretreatment group.After pretreatment with different doses of Astragalus,each group of mice received intraperitoneal injection of Streptozotocin(STZ) in order to induce DM,and then the incidence of DM was observed.Serum nitric oxide (NO)was measured by the nitratase method,the activity of induced nitric oxide synthase(iNOS) was measured by chemical colorimetric method,and insulin level was detected by enzyme linked immunosorbent assay method.Insulitis score was evaluated according to pancreatic histology.Islet β cell apoptosis was measured by using a terminal dexynucleotidyl transferase(TdT)-mediated dUTP nick end labeling assay.Results 1.DM attack began 1 week after STZ injection in DM group.Pretreatment with 30 g/(kg · d) of Astragalus,DM appeared 2 weeks after STZ injection.Compared with DM group,the onset of DM was delayed,and the incidence of DM was significantly reduced(P ＜ 0.01).After pretreatment with 15 g/(kg · d) of Astragalus,the DM began 1 week after STZ injection,compared with DM group,the incidence of DM was reduced,but there was no statistical difference(P ＞ 0.05).2.Compared with DM group,after pretreatment with 30 g/(kg · d) of Astragalus,the activity of iNOS was significantly inhibited(all P ＜ 0.01),and then NO level significantly declined(all P ＜ 0.01),and the insulitis score and apoptosis of β cells were also significantly decreased (all P ＜ 0.01) ;after pretreatment with 15 g/(kg · d) of Astragalus,there was no statistical difference in all the indexes (all P ＞ 0.05).Conclusions Astragalus can protect islet β cells of mice in vivo,which is associated with its inhibition on the iNOS activity,reduction on NO generation,and can decrease β cells insulitis and apoptosis.Therefore,improving the body free radicals scavenger ability may prevent and delay the occurrence of DM.

Objective To evaluate the clinical features of Rathke cleft cysts(RCCs) in children diagnosed by pituitary magnetic resonance(MR) and their features on MR.Methods Twenty-two children with RCCs aged 2-18 years old who visited the Affiliated Hospital of Qingdao University Medical College between Jan.2002 and Feb.2012 were enrolled.RCCs was conformed by pituitary MR.The clinical symptoms and imaging features were reviewed retrospectively.Results The clinical presentation of symptomatic children were as follows:endocrinopathy in 13 cases (59.1％),headache in 5 cases(22.7％) and visual disturbance in 1 case(4.5％) and variety of symptoms in 3 cases (13.6％),which including 1 case of short stature and dysgenitalism,1 case of type 1 diabetes with electrolyte disorder and the other of headache associated with visual impairment.Endocrinopathy included short stature 5 cases(22.7％),precocious puberty 4 cases(18.2％)and diabetes insipidus 4 cases(18.2％).Generally,RCCs appeared various on Tl-weighted MR,whereas on T2-weighted sequences the signal intensity was mostly high.High signals in the T1-weighted image on brain MR were related to pituitary hormone deficiency.Hypointensity of the cysts in T1-weighted was appeared when enhanced images.Conclusions The most common clinical manifestation of children with RCCs is endocrinopathy.Pituitary MR shows a certain characteristics and it is favorable in agreement with pathological diagnosis.MR may be of predictive value for the preoperative diagnosis.

OBJECTIVETo study the alveolar bone surrounding situation and the length of the root of the maxillary labial inverted impacted incisor in mixed dentition after orthodontic treatment.

METHODSFourteen cases with maxillary labial inverted impacted incisor in mixed dentition were collected. Modified Nance arch and conventional appliance were used. Cone-bean CT (CBCT) was taken after the treatment. Simplant13.0 three-dimensional reconstruction and multi-planer reconstruction (MPR) method were used to observe the labial and lingual alveolar bone crest morphology, besides, the labial and lingual length from the alveolar bone crest to cemento-enamel junction (CEJ) of the impacted incisor and the homonym tooth after treatment, along with their root length and their labial and lingual length ratio of the root surrounded by the alveolar bone to the total root length were measured. The idependent samples t-test were used to analyze the variable differences.

RESULTSThe labial and lingual alveolar bone of fourteen cases crest of the diseased tooth after treatment presented general symmetry U shape from qualitative observation through the three-dimensional reconstruction. The labial and the lingual length of the diseased incisor from alveolar bone crest to CEJ [(2.47 ± 1.35) and (1.47 ± 0.84) mm] was significant increased than those of the homonym incisor [(1.03 ± 0.35) and (0.90 ± 0.37) mm] (P < 0.05); the length of the diseased incisor's post-treatment root [(9.82 ± 2.82) mm] was no statistically significant decreased than that of the homonym incisor root [(10.28 ± 1.38) mm, P = 0.59]; the labial and the lingual length ratio of the impacted tooth's root surrounded by the alveolar bone to the total root length [(72.83 ± 17.16)% and (85.32 ± 5.98)%] was statistically significant decrease than those of homonym teeth[(89.66 ± 3.98)% and (90.84 ± 4.61)%] (P < 0.05).

CONCLUSIONSThe diseased tooth's root had gotten enough length after the treatment. The labial and lingual alveolar bone of the maxillary labial inverted impacted incisor in mixed dentition can't offer sufficient adaptive hyperplasia after treatment, of which labial alveolar bone is more apparent, prompting careful protection when they were used.

Alveolar Process ; diagnostic imaging ; pathology ; Child ; Cone-Beam Computed Tomography ; Dentition, Mixed ; Female ; Follow-Up Studies ; Humans ; Incisor ; diagnostic imaging ; pathology ; surgery ; Male ; Maxilla ; diagnostic imaging ; pathology ; surgery ; Orthodontic Extrusion ; Tooth Root ; diagnostic imaging ; pathology ; Tooth, Impacted ; diagnostic imaging ; surgery

OBJECTIVETo investigate the frequencies and distribution of CD4+ T cells and CD8+ T cells as well as the changes of immune activation in gastric mucosa of HIV-infected individuals.

METHODS42 HIV-infected individuals were recruited into this investigation, and 36 patients had definite diagnosis of clinical stage. Biopsy of gastric mucosal tissues was performed by fiberoptic gastroscope including 10 normal people as a control group. Then, immunohistochemistry was used to detect expression of CD4, CD8 and CD38 in gastric mucosa, and the distinctions among three groups were analyzed with LEICA Qwin image analysis system.

RESULTS(1) Compared with asymptomatic HIV carriers and control group, CD4 T cells remarkably decreased in the gastric mucosa of AIDS patients (P < 0.01). In gastric mucosa of asymptomatic HIV carriers, there were still some CD4+ T cells in lymphoid follicles and stroma where CD4+ T cells were unevenly distributed, the frequency of CD4+ T cells was not significantly different between asymptomatic HIV carriers and control group (P > 0.05); (2) Phenomenon of CD8+ T cells infiltrating mucosal epithelium and gland was general in HIV-infected individuals. CD8+ T cells took on local excessive hyperplasia in gastric mucosa of some individuals. As compared with control group, CD8+ T cells markedly increased in gastric mucosa of infected individuals (P < 0.01), but the distinction of asymptomatic HIV carriers and AIDS patients was not significant (P > 0.05); (3) CD38-expressing cells mainly distributed over gastric mucosal surface to superficial layer(1/3-2/3 layer) of HIV-infected individuals, and was more intensive than control group (P < or = 0.01), but there was not noticeable difference between asymptomatic HIV carriers and AIDS patients (P > 0.05).

CONCLUSIONThe frequencies and distribution of gastric mucosal CD4+ T cells of HIV-infected individuals were closely correlated with progression of disease. Disfunction of mucosal immune system which was resulted from HIV infection and injury of CD4+ T cells could be an important cause of CD8+ T cells increasing and CD38-expressing enhancement.

ADP-ribosyl Cyclase 1 ; genetics ; immunology ; Adult ; CD4-Positive T-Lymphocytes ; cytology ; immunology ; CD8-Positive T-Lymphocytes ; cytology ; immunology ; Female ; Gastric Mucosa ; immunology ; Gene Expression ; HIV Infections ; genetics ; immunology ; HIV-1 ; immunology ; Humans ; Lymphocyte Count ; Male ; Middle Aged

OBJECTIVETo compare the sonographic findings with pathological features of ovarian thecoma, and to analyze the relationship between them.

METHODSThe sonograms of 45 ovarian thecoma cases were reviewed retrospectively and categorized into three subtypes as sound attenuation pattern, homogeneous hypoechoic pattern and solid and cystic mixed pattern. The pathological findings were classified as theca cell-predominant, fibroblast-predominant and mixed thecoma according to the cellular composition of the tumors. Hyaline degeneration and luteinization of the tumors were recorded. The pathologic findings of each subtype based on sonography were compared.

RESULTSOf the 45 patients, there were 34 (75.6%) solid ovarian lesions, 15 (33.3%) of those showed a sound-attenuation pattern with an anterior hypoechoic zone and posterior acoustic attenuation in sonography, the other 19 (42.2%) cases had homogeneous hypoechoic pattern with no posterior acoustic attenuation, and the remaining 11 (24.4%) cases presented as a solid and cystic mixed pattern. There were no significant differences in pathological cellular composition among the three sonographic subtypes. Five solid tumors containing hyaline degeneration and one with luteinization were found to have posterior acoustic attenuation. The solid and cystic mixed thecomas showed cystic degeneration and hemorrhage.

CONCLUSIONSolid ovarian thecomas usually have typical sonographic features, which may be associated with degeneration but not with cellular composition within the tumor.

Adult ; Aged ; Aged, 80 and over ; CA-125 Antigen ; blood ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; blood ; classification ; diagnostic imaging ; pathology ; Retrospective Studies ; Thecoma ; blood ; classification ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color ; methods ; Young Adult

OBJECTIVETo explore the role of CD4⁺ CD25⁺ Foxp3⁺ Treg/CD4⁺ IL-17A(+)Th17 cells and the related cytokines in Graves' ophthalmopathy.

METHODSBased on clinical activity scores (CAS), we divided patients with untreated Graves' ophthal- mopathy into active group (AGO group with CAS ≥ 3 (15 cases) and non-active group (NGO group) with CAS<3 (15 cases), with another 15 patients with untreated Graves' disease free of eye symptoms (GD group) and 15 normal subjects as controls. Peripheral venous blood Treg/Th17 cell ratio was determined using flow cytometry. RT-PCR was used to detect the mRNA expression levels of Treg-specific transcription factor Foxp3 and Th17-specific transcription factor RORγt. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of Th17 cell-related cytokines (IL-17A, IL-23, and IL-6) and Treg-related cytokines (TGF-β, IL-10, and IL-35).

RESULTSCompared with the normal subjects, the patients in GD, NGO, AGO groups all showed significantly increased Th17 cell count (P<0.05), which was the highest in AGO group. RT-PCR results revealed significantly increased RORγt in GD, NGO, and AGO groups, also the highest in AGO group. Serum IL-17A, IL-23, and IL-6 levels all showed significant increments in GD, NGO, and AGO groups (P<0.05), especially in AGO group. Among the Treg-related cytokines, TGF-β and IL-35 levels decreased (P<0.05) but IL-10 increased significantly (P<0.05) in GD, NGO, AGO groups.

CONCLUSIONDecreased immunosuppressive capacity of Treg cells can be an important factor in the pathogenesis of Graves' ophthalmopathy. Th17 cells may also participate in the occurrence and progression of Graves' ophthalmopathy and can serve along with related cytokines as novel indicators of the disease activity. Impaired Treg/Th17 balance may importantly contribute to the occurrence of Graves' ophthalmopathy.

Cytokines ; immunology ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Graves Ophthalmopathy ; immunology ; Humans ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology